Negotiated reimbursement rates for D5909 across 2 states, sourced from CMS Transparency in Coverage data. 9 rate records.
D5909 refers to a removable prosthesis adjustment performed on a by-report basis. This procedure is indicated when a prosthesis requires minor adjustments for fit, comfort, or function. Documentation should include details of the adjustments made and the patient's feedback regarding the prosthesis. Since this procedure is billed by report, it may require additional notes or justification to support the claim. Reimbursement for this adjustment can vary widely depending on the payor and state, with an average reimbursement of about $7. Some insurers may have specific policies regarding adjustments, which can impact the approval and payment process.
Reimbursement rates for D5909 vary significantly by state, payor, and provider network. The national average negotiated rate is $7. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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