Negotiated reimbursement rates for D4342 across 43 states, sourced from CMS Transparency in Coverage data. 247 rate records.
D4342 refers to scaling and root planing for one to three teeth per quadrant. This procedure is indicated for localized areas of periodontal disease where targeted treatment is required. Documentation should include clinical findings, periodontal measurements, and the specific teeth treated. When billing, it is essential to clearly indicate the rationale for the limited scaling and root planing. Reimbursement for D4342 can vary by insurance provider and state, with an average reimbursement of about $108. Some payors may have specific criteria for coverage, so it is important to verify benefits beforehand.
Reimbursement rates for D4342 vary significantly by state, payor, and provider network. The national average negotiated rate is $108. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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