Negotiated reimbursement rates for D4381 across 32 states, sourced from CMS Transparency in Coverage data. 184 rate records.
Localized Antimicrobial Delivery (Per Tooth) involves the application of antimicrobial agents directly into periodontal pockets to combat localized infections. This procedure is indicated for patients with specific periodontal issues where localized treatment is necessary. Proper documentation should include the specific teeth treated, the antimicrobial agent used, and the clinical rationale for its use. Reimbursement for this procedure averages around $68 but can vary widely by payor and state, with some plans requiring prior authorization or limiting coverage based on the severity of the periodontal condition.
Reimbursement rates for D4381 vary significantly by state, payor, and provider network. The national average negotiated rate is $68. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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