Negotiated reimbursement rates for D0191 across 25 states, sourced from CMS Transparency in Coverage data. 103 rate records.
D0191 refers to the assessment of a patient, which is a crucial initial step in the dental care process. This procedure is typically used when a patient presents for a new evaluation or when there is a change in their oral health status. Documentation for this procedure should include a thorough review of the patient's medical and dental history, clinical examination findings, and any necessary diagnostic tests. Billing for D0191 may vary by payor, with some insurers covering it as part of a comprehensive evaluation while others may require additional documentation or specific circumstances for reimbursement. Average reimbursement for this code is around $27, but it can differ based on state regulations and the specific policies of individual insurance providers.
Reimbursement rates for D0191 vary significantly by state, payor, and provider network. The national average negotiated rate is $27. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
22+ more states available with Pro ↓
| State | Avg Rate |
|---|---|
| Pennsylvania | $95 |
| New York | $71 |
| North Dakota | $53 |
| Nevada | $35 |
| District of Columbia | $31 |
| State | Avg Rate |
|---|---|
| Iowa | $8 |
| Idaho | $8 |
| Kansas | $8 |
| Missouri | $8 |
| Tennessee | $8 |