Negotiated reimbursement rates for D0804 across 3 states, sourced from CMS Transparency in Coverage data. 21 rate records.
D0804 refers to a 3D surface scan performed post-restorative treatment. This procedure utilizes advanced imaging technology to create a three-dimensional representation of a patient's dental anatomy, which is particularly useful for assessing the success of restorations and planning further treatment if necessary. Clinical indications for this procedure include evaluating the fit and function of crowns, bridges, or other restorations. Documentation should include the reason for the scan, details of the restorative work performed, and any findings from the scan. Reimbursement for D0804 can vary significantly by payor and state, with some plans covering it under diagnostic imaging benefits, while others may consider it an adjunctive service with limited coverage. It's crucial to verify specific payor policies to ensure proper billing and maximize reimbursement potential.
Reimbursement rates for D0804 vary significantly by state, payor, and provider network. The national average negotiated rate is $93. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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| State | Avg Rate |
|---|---|
| Nevada | $101 |
| California | $82 |
| Utah | $70 |
| State | Avg Rate |
|---|---|
| Nevada | $101 |
| California | $82 |
| Utah | $70 |