Negotiated reimbursement rates for D1520 across 44 states, sourced from CMS Transparency in Coverage data. 508 rate records.
D1520 refers to a removable unilateral space maintainer, which is utilized to preserve space in the dental arch for a permanent tooth that has not yet erupted. This type of space maintainer is indicated when a primary tooth is lost, and it is essential to prevent adjacent teeth from drifting into the space. Documentation for billing D1520 should include the clinical rationale for the space maintainer, the patient's dental history, and any relevant radiographic evidence. The average reimbursement for this procedure is approximately $237, but it can differ based on the patient's insurance plan and state regulations. Some payors may have specific coverage policies or limitations on removable devices.
Reimbursement rates for D1520 vary significantly by state, payor, and provider network. The national average negotiated rate is $237. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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