Negotiated reimbursement rates for D9311 across 36 states, sourced from CMS Transparency in Coverage data. 252 rate records.
D9311 refers to a consultation with another dentist or physician. This procedure is typically indicated when a dentist seeks a second opinion or additional expertise regarding a patient's diagnosis or treatment plan. Proper documentation is crucial for billing this code, including detailed notes on the consultation's purpose, findings, and any recommendations made. Reimbursement for D9311 can vary significantly by payor and state, with some insurers offering higher rates for consultations involving specialists. It's important to verify coverage and obtain prior authorization when necessary, as some payors may have specific guidelines for consultations.
Reimbursement rates for D9311 vary significantly by state, payor, and provider network. The national average negotiated rate is $84. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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