Negotiated reimbursement rates for D1355 across 24 states, sourced from CMS Transparency in Coverage data. 172 rate records.
D1355 is the code for Caries Preventive Medicament Application, which involves applying a medicament to prevent carious lesions. This procedure is clinically indicated for patients at high risk for caries, particularly children and those with special health care needs. Documentation should include the type of medicament used and the rationale for its application. Reimbursement for D1355 varies by payor, with some insurance plans covering it as a preventive service while others may have restrictions. The average reimbursement for this procedure is approximately $41.
Reimbursement rates for D1355 vary significantly by state, payor, and provider network. The national average negotiated rate is $41. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
21+ more states available with Pro ↓
| State | Avg Rate |
|---|---|
| New Jersey | $72 |
| New York | $69 |
| Georgia | $64 |
| Connecticut | $60 |
| Virginia | $45 |
| State | Avg Rate |
|---|---|
| South Carolina | $23 |
| Kansas | $22 |
| Nevada | $21 |
| Arizona | $18 |
| Utah | $16 |