Negotiated reimbursement rates for D9225 across 43 states, sourced from CMS Transparency in Coverage data. 427 rate records.
D9225 is used for each additional 15 minutes of deep sedation or general anesthesia administered by a dentist. This code is often billed in conjunction with D9224 when the procedure exceeds the initial 15 minutes. Clinical indications remain the same, focusing on patient comfort and safety during extensive dental procedures. Proper documentation is essential, including the total time of sedation, patient monitoring details, and any complications that may arise. Reimbursement for D9225 also varies by payor and state, with some insurers providing coverage based on the medical necessity of the procedure and the patient's condition, while others may impose limits on the total time or frequency of sedation services.
Reimbursement rates for D9225 vary significantly by state, payor, and provider network. The national average negotiated rate is $116. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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