Negotiated reimbursement rates for D5954 across 1 states, sourced from CMS Transparency in Coverage data. 3 rate records.
D5954 refers to a Palatal Augmentation Prosthesis, a device designed to improve speech and swallowing in patients with palatal deficiencies. Clinical indications for this procedure include patients who have undergone surgical interventions or have congenital conditions affecting the palate. Documentation should include a comprehensive assessment of the patient's oral and speech capabilities, along with the specific design and purpose of the prosthesis. Reimbursement for D5954 varies widely among payors and states, with some insurers covering the procedure while others may not. The average reimbursement for this procedure is approximately $1, emphasizing the need for dental billing professionals to be diligent in confirming coverage details with payors.
Reimbursement rates for D5954 vary significantly by state, payor, and provider network. The national average negotiated rate is $1. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
-2+ more states available with Pro ↓
| State | Avg Rate |
|---|---|
| New York | $2,511 |
| State | Avg Rate |
|---|---|
| New York | $2,511 |