Negotiated reimbursement rates for D9420 across 46 states, sourced from CMS Transparency in Coverage data. 446 rate records.
D9420 is designated for hospital or ambulatory surgical center (ASC) calls, where dental services are provided in a hospital setting. This code is typically used for patients requiring sedation or those with complex medical conditions that necessitate treatment in a controlled environment. Documentation must detail the patient's medical history, the reason for the hospital visit, and the procedures performed. Reimbursement for D9420 can be higher than standard office visits, but it varies by payor and state regulations, with some insurers requiring pre-authorization for hospital-based services.
Reimbursement rates for D9420 vary significantly by state, payor, and provider network. The national average negotiated rate is $215. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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