Negotiated reimbursement rates for D8091 across 36 states, sourced from CMS Transparency in Coverage data. 269 rate records.
D8091 is the code for Comprehensive Orthodontic treatment billed 'By Report.' This code is used when the orthodontic treatment plan is complex or unique, requiring additional documentation to justify the services rendered. Clinical indications may include cases that do not fit standard treatment protocols or when multiple modalities are employed. Proper documentation is crucial, and it should include a comprehensive treatment plan, clinical notes, and any relevant diagnostic records. Reimbursement for D8091 varies widely among payors and states, as it often depends on the specifics of the case presented. Average reimbursement is approximately $4, but actual amounts can differ based on the insurance provider's policies and the complexity of the treatment.
Reimbursement rates for D8091 vary significantly by state, payor, and provider network. The national average negotiated rate is $4. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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