Caries Risk Assessment — High Risk (D0603) — National Rates

Negotiated reimbursement rates for D0603 across 14 states, sourced from CMS Transparency in Coverage data. 86 rate records.

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National Average Negotiated Rate
$31
86 rate records · 14 states
📊 Data updated monthly · Last refresh: March 2026

About D0603 — Caries Risk Assessment — High Risk

Caries Risk Assessment - High Risk is a procedure used to evaluate a patient's likelihood of developing dental caries. This assessment is crucial for patients identified as high risk due to factors such as a history of caries, poor oral hygiene, or dietary habits. Documentation for this procedure should include a detailed patient history, clinical findings, and any relevant risk factors. Billing for this service may vary by payor, with some insurance plans covering it fully while others may require additional documentation or may not reimburse at all. It is essential to check specific payor policies and state regulations to ensure proper reimbursement.

Reimbursement rates for D0603 vary significantly by state, payor, and provider network. The national average negotiated rate is $31. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.

Top Paying States for D0603

Virginia
$47
1 records
Utah
$45
1 records
Nevada
$43
9 records

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Full National Breakdown

Median
$28
Low
$2
High
$100

Highest & Lowest Reimbursement States

↑ Top 5

StateAvg Rate
Virginia$47
Utah$45
Nevada$43
New York$42
Arizona$40

↓ Bottom 5

StateAvg Rate
Florida$22
California$19
New Jersey$16
Maryland$8
Pennsylvania$3

All States — D0603 Average Rates

Virginia
$47
Utah
$45
Nevada
$43
New York
$42
Arizona
$40
Kentucky
$38
Georgia
$35
Texas
$29
Indiana
$28
Florida
$22
California
$19
New Jersey
$16
Maryland
$8
Pennsylvania
$3
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State-by-State Comparison Table

StateAverageMedianMinMaxRecords
Virginia$47$47$47$471
Utah$45$45$45$451
Nevada$43$44$36$519
New York$42$41$29$625
Arizona$40$46$11$558
Kentucky$38$38$38$381
Georgia$35$32$12$4615
Texas$29$30$17$406
Indiana$28$28$28$281
Florida$22$25$13$273
California$19$20$2$5526
New Jersey$16$13$10$275
Maryland$8$8$8$81
Pennsylvania$3$3$3$31
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