Negotiated reimbursement rates for D0470 across 33 states, sourced from CMS Transparency in Coverage data. 323 rate records.
The CDT code D0470 refers to the creation of a diagnostic cast, which is a replica of a patient's dental arch used for treatment planning and evaluation. This procedure is clinically indicated for orthodontic assessments, prosthodontic planning, and other dental evaluations where a physical model is necessary. Proper documentation should include the reason for the cast creation, the specific treatment plan, and any relevant clinical findings. Billing for this procedure typically sees reimbursement rates averaging around $71, but this can vary significantly by payor and state. Some insurance plans may have specific criteria for coverage, while others may consider it part of a broader treatment plan, affecting reimbursement rates accordingly.
Reimbursement rates for D0470 vary significantly by state, payor, and provider network. The national average negotiated rate is $71. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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| State | Avg Rate |
|---|---|
| Nevada | $109 |
| Washington | $103 |
| North Dakota | $98 |
| California | $89 |
| South Carolina | $88 |
| State | Avg Rate |
|---|---|
| Tennessee | $35 |
| Minnesota | $35 |
| Iowa | $30 |
| Kansas | $29 |
| Massachusetts | $29 |