Caries Risk Assessment — Low Risk (D0601) — National Rates

Negotiated reimbursement rates for D0601 across 16 states, sourced from CMS Transparency in Coverage data. 83 rate records.

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National Average Negotiated Rate
$27
83 rate records · 16 states
📊 Data updated monthly · Last refresh: March 2026

About D0601 — Caries Risk Assessment — Low Risk

D0601 is a caries risk assessment code specifically for patients identified as low risk for caries development. This assessment involves evaluating factors such as oral hygiene practices, dietary habits, and previous caries history. Clinical indications for this procedure include preventive care planning and patient education. Documentation should include the assessment findings, patient history, and any recommendations made. Reimbursement for D0601 averages about $27, but may differ among payors. Some may cover the procedure fully, while others may have specific criteria that must be met for reimbursement.

Reimbursement rates for D0601 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.

Top Paying States for D0601

Colorado
$49
1 records
Nevada
$42
9 records
New York
$37
8 records

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Full National Breakdown

Median
$26
Low
$3
High
$100

Highest & Lowest Reimbursement States

↑ Top 5

StateAvg Rate
Colorado$49
Nevada$42
New York$37
South Carolina$35
Virginia$35

↓ Bottom 5

StateAvg Rate
Arizona$20
California$18
Indiana$12
Kentucky$10
Oregon$8

All States — D0601 Average Rates

Colorado
$49
Nevada
$42
New York
$37
South Carolina
$35
Virginia
$35
Illinois
$31
Georgia
$31
Wisconsin
$27
Missouri
$26
Tennessee
$24
New Jersey
$23
Arizona
$20
California
$18
Indiana
$12
Kentucky
$10
Oregon
$8
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State-by-State Comparison Table

StateAverageMedianMinMaxRecords
Colorado$49$49$49$491
Nevada$42$40$36$509
New York$37$38$16$548
South Carolina$35$35$35$351
Virginia$35$35$35$351
Illinois$31$31$31$311
Georgia$31$24$24$428
Wisconsin$27$25$25$318
Missouri$26$26$26$261
Tennessee$24$24$24$241
New Jersey$23$22$13$354
Arizona$20$20$20$202
California$18$16$3$5132
Indiana$12$12$12$121
Kentucky$10$10$10$101
Oregon$8$8$8$81
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