Negotiated reimbursement rates for D5939 across 1 states, sourced from CMS Transparency in Coverage data. 4 rate records.
The D5939 code is for a Trismus Appliance without expansion capability, aimed at patients with limited jaw movement due to various medical conditions. This appliance helps maintain oral function and hygiene by providing a stable oral environment. Clinical indications include post-operative patients or those with conditions that restrict jaw movement. Proper documentation should include a comprehensive clinical evaluation, treatment plan, and notes on the patient's condition. Average reimbursement for this appliance is around $3, but it can vary by payor and state, with some insurance plans offering limited coverage or requiring prior authorization. Understanding the specific requirements of each payor is essential for successful billing.
Reimbursement rates for D5939 vary significantly by state, payor, and provider network. The national average negotiated rate is $3. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
-2+ more states available with Pro ↓
| State | Avg Rate |
|---|---|
| New York | $4,935 |
| State | Avg Rate |
|---|---|
| New York | $4,935 |