Negotiated reimbursement rates for D0419 across 2 states, sourced from CMS Transparency in Coverage data. 10 rate records.
D0419 is designated for biofilm pathogen assessment, a procedure that evaluates the microbial composition of dental biofilm to identify pathogenic organisms that may contribute to oral diseases. This assessment is clinically indicated for patients with a history of periodontal disease or those at high risk for caries. Documentation should include the rationale for the assessment, the findings, and any treatment recommendations based on the results. Reimbursement for this service can vary widely depending on the insurance provider and state regulations, with some plans recognizing it as a necessary diagnostic tool, while others may not cover it at all. The average reimbursement for this code is around $42.
Reimbursement rates for D0419 vary significantly by state, payor, and provider network. The national average negotiated rate is $42. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
-1+ more states available with Pro ↓
| State | Avg Rate |
|---|---|
| Florida | $40 |
| California | $36 |
| State | Avg Rate |
|---|---|
| Florida | $40 |
| California | $36 |