Negotiated reimbursement rates for D5120 across 48 states, sourced from CMS Transparency in Coverage data. 910 rate records.
D5120 is the code for a complete lower denture, similar to D5110 but specifically for the lower arch. This procedure is indicated for patients who have lost all their lower teeth and require a removable prosthesis to restore function and aesthetics. Documentation should include a thorough assessment of the patient's oral health, treatment planning notes, and any diagnostic imaging that supports the need for the denture. Reimbursement for D5120 can vary significantly by payor and state, with some insurance plans offering full coverage while others may have limitations or exclusions. The average reimbursement for this code is also around $1, indicating that additional costs may be incurred for related procedures or materials. Dental professionals should check with individual payors to understand coverage specifics and ensure proper billing practices.
Reimbursement rates for D5120 vary significantly by state, payor, and provider network. The national average negotiated rate is $1. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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