Negotiated reimbursement rates for D5993 across 26 states, sourced from CMS Transparency in Coverage data. 112 rate records.
D5993 covers the maintenance and cleaning of a maxillofacial prosthesis, which is vital for ensuring the longevity and functionality of the appliance. Clinical indications for this procedure include routine maintenance or issues such as staining or odor. Documentation should detail the type of prosthesis, the cleaning methods used, and any patient-reported issues. Reimbursement for this service averages around $300, but it can differ based on the payor's policies and the state, with some insurers offering limited coverage for maintenance procedures.
Reimbursement rates for D5993 vary significantly by state, payor, and provider network. The national average negotiated rate is $300. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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