Negotiated reimbursement rates for D5284 across 49 states, sourced from CMS Transparency in Coverage data. 690 rate records.
D5284 refers to a Removable Unilateral Partial Denture made of flexible material, designed for patients who prefer a more comfortable and adaptable solution for a single-sided edentulous space. Clinical indications include the need for a prosthesis that can accommodate changes in the oral environment. Documentation should include treatment planning, patient consent, and detailed clinical notes. The average reimbursement for this procedure is around $594, but it can vary widely depending on the patient's insurance and state regulations. Some payors may have specific criteria for flexible dentures, which can affect coverage. Dental billing professionals should be diligent in confirming coverage details and ensuring accurate claims submission to facilitate reimbursement.
Reimbursement rates for D5284 vary significantly by state, payor, and provider network. The national average negotiated rate is $594. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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