Negotiated reimbursement rates for D5867 across 43 states, sourced from CMS Transparency in Coverage data. 449 rate records.
D5867 involves the replacement of an attachment for an implant overdenture. This procedure is clinically indicated when the existing attachment has become worn or damaged, impacting the stability and function of the overdenture. Documentation should include details of the existing attachment's condition and any clinical notes regarding the patient's ongoing treatment. Reimbursement for this procedure can vary significantly by payor and state, with some insurance plans covering the cost while others may consider it a patient responsibility. It's crucial to verify coverage details before proceeding with the replacement.
Reimbursement rates for D5867 vary significantly by state, payor, and provider network. The national average negotiated rate is $120. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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