Negotiated reimbursement rates for D6251 across 48 states, sourced from CMS Transparency in Coverage data. 724 rate records.
D6251 refers to a Bridge Pontic made of resin with a base metal. This procedure involves the placement of a pontic, which is the artificial tooth that fills the gap left by a missing tooth, supported by adjacent teeth. Clinical indications for this procedure include the need for a fixed prosthesis to restore function and aesthetics in patients with missing teeth. Proper documentation should include a detailed treatment plan, radiographs, and notes on the patient's oral health status. Reimbursement for this code can vary significantly by payor and state, with average reimbursements around $623. Some insurance plans may have specific limitations on the materials used, which can affect coverage. It is essential to verify benefits before treatment to ensure proper billing and reimbursement.
Reimbursement rates for D6251 vary significantly by state, payor, and provider network. The national average negotiated rate is $623. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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