Negotiated reimbursement rates for D9219 across 25 states, sourced from CMS Transparency in Coverage data. 80 rate records.
D9219 is the code for Evaluation for Moderate Sedation, which involves assessing a patient’s readiness for moderate sedation during dental procedures. This evaluation is crucial for ensuring patient safety and determining the appropriate sedation level. Clinical indications include procedures that may cause significant discomfort or anxiety, such as surgical extractions or complex restorative work. Documentation must include the patient's medical history, vital signs, and any pre-sedation assessments. Reimbursement for D9219 averages around $67, but varies by payor and state, with some insurers requiring specific documentation to justify the evaluation.
Reimbursement rates for D9219 vary significantly by state, payor, and provider network. The national average negotiated rate is $67. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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