Negotiated reimbursement rates for D5955 across 1 states, sourced from CMS Transparency in Coverage data. 3 rate records.
D5955 is the CDT code for a Definitive Palatal Lift Prosthesis, which is utilized to assist patients with velopharyngeal insufficiency, improving their ability to speak and swallow effectively. Clinical indications include conditions such as cleft palate or neurological disorders that affect muscle function in the palate. Documentation must include a thorough evaluation of the patient's condition, treatment objectives, and the design specifics of the prosthesis. Reimbursement for D5955 varies by payor, with some providing comprehensive coverage while others may impose restrictions. The average reimbursement for this procedure is around $5, highlighting the necessity for dental billing professionals to navigate the complexities of insurance policies and ensure appropriate billing practices.
Reimbursement rates for D5955 vary significantly by state, payor, and provider network. The national average negotiated rate is $5. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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