Negotiated reimbursement rates for D9936 across 7 states, sourced from CMS Transparency in Coverage data. 19 rate records.
D9936 pertains to the replacement of a device or appliance specifically for obstructive sleep apnea (OSA). This procedure is clinically indicated when a patient requires a new device due to failure, wear, or changes in their condition. Documentation should include the patient's diagnosis, the reason for replacement, and any relevant treatment history. The average reimbursement for this procedure is about $33, but it can vary widely by payor and state. Some insurance plans may cover this service under durable medical equipment (DME), while others may have specific limitations or require prior authorization, affecting the overall reimbursement process.
Reimbursement rates for D9936 vary significantly by state, payor, and provider network. The national average negotiated rate is $33. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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