Negotiated reimbursement rates for D1526 across 43 states, sourced from CMS Transparency in Coverage data. 529 rate records.
D1526 is the code for a removable bilateral space maintainer for the maxillary arch. This device is indicated when multiple primary teeth are lost, and it is crucial to maintain the space for the eruption of permanent teeth. Proper documentation is vital for billing D1526, including clinical notes, the rationale for the space maintainer, and any necessary radiographs. The average reimbursement for this procedure is around $362, but this can vary significantly by payor and state. Insurance coverage may differ, with some plans offering full reimbursement while others may impose limitations based on the patient's age or specific dental plan provisions.
Reimbursement rates for D1526 vary significantly by state, payor, and provider network. The national average negotiated rate is $362. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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