Negotiated reimbursement rates for D9959 across 1 states, sourced from CMS Transparency in Coverage data. 3 rate records.
D9959 is used for a custom sleep apnea appliance, billed by report. This procedure involves creating a tailored oral appliance for patients diagnosed with obstructive sleep apnea. Clinical indications include a confirmed diagnosis of sleep apnea and the need for a custom solution to improve airway function during sleep. Documentation must include a comprehensive report detailing the patient's diagnosis, treatment plan, and the specifics of the appliance design. Reimbursement for this code is typically low, averaging around $5, and varies significantly by payor and state, with some plans offering limited or no coverage for custom appliances.
Reimbursement rates for D9959 vary significantly by state, payor, and provider network. The national average negotiated rate is $5. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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