Negotiated reimbursement rates for D1527 across 48 states, sourced from CMS Transparency in Coverage data. 538 rate records.
D1527 refers to a removable bilateral space maintainer for the mandibular arch, typically used in pediatric dentistry. This device is crucial for maintaining space in the dental arch after the premature loss of primary teeth, preventing adjacent teeth from drifting and ensuring proper alignment for future permanent teeth. Clinical indications include the loss of one or more primary molars due to caries or trauma. Documentation for this procedure should include the reason for space maintenance, a clinical examination, and any radiographic evidence of tooth loss. Reimbursement for D1527 can vary significantly by payor and state, with average fees around $379. Some insurance plans may cover this procedure under preventive services, while others may classify it as a restorative service, impacting patient out-of-pocket costs.
Reimbursement rates for D1527 vary significantly by state, payor, and provider network. The national average negotiated rate is $379. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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