Negotiated reimbursement rates for D0416 across 6 states, sourced from CMS Transparency in Coverage data. 24 rate records.
The CDT code D0416 is designated for Viral Culture Specimen Collection, a procedure where a specimen is collected to test for viral infections. This test is clinically indicated when a dental professional suspects a viral infection that could affect oral health or overall treatment. Documentation should include the type of specimen collected, the clinical rationale for the test, and any relevant patient history. The average reimbursement for this service is approximately $47, but it can vary widely depending on the specific insurance plan and state regulations. Some payors may have specific guidelines regarding coverage, and it is crucial for billing professionals to verify these details to ensure proper reimbursement.
Reimbursement rates for D0416 vary significantly by state, payor, and provider network. The national average negotiated rate is $47. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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| State | Avg Rate |
|---|---|
| Pennsylvania | $66 |
| New York | $47 |
| California | $44 |
| South Carolina | $42 |
| District of Columbia | $24 |
| State | Avg Rate |
|---|---|
| New York | $47 |
| California | $44 |
| South Carolina | $42 |
| District of Columbia | $24 |
| New Jersey | $22 |