Negotiated reimbursement rates for D1120 across 39 states, sourced from CMS Transparency in Coverage data. 386 rate records.
D1120 is the code for child prophylaxis, which is a preventive dental cleaning specifically for pediatric patients. This procedure is designed to remove plaque and calculus from the teeth of children, helping to prevent cavities and promote good oral hygiene habits. Clinical indications for D1120 include routine cleanings for children with healthy teeth and gums or those at risk for dental caries. Documentation should include the child's dental history, any findings from the examination, and the cleaning performed. Reimbursement for D1120 can vary by payor and state, with many insurance plans covering this procedure as part of preventive services for children. It's essential to check the specific coverage policies of each payor to ensure accurate billing and maximize reimbursement.
Reimbursement rates for D1120 vary significantly by state, payor, and provider network. The national average negotiated rate is $74. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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