Negotiated reimbursement rates for D5925 across 2 states, sourced from CMS Transparency in Coverage data. 20 rate records.
D5925 refers to the Facial Augmentation Prosthesis, which is a custom-made prosthetic device designed to improve facial aesthetics and function for patients with facial deformities or defects. Clinical indications for this procedure include congenital anomalies, trauma, or surgical resection of facial structures. Documentation for billing should include a detailed description of the patient's condition, the specific prosthesis fabricated, and any relevant clinical notes that support the necessity of the procedure. Reimbursement for D5925 can vary significantly by payor and state, with some insurance plans covering a portion of the costs while others may consider it cosmetic and not reimbursable. Average reimbursement is around $41, but dental billing professionals should verify coverage specifics with each payor to ensure proper claims submission and payment processing.
Reimbursement rates for D5925 vary significantly by state, payor, and provider network. The national average negotiated rate is $41. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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