Negotiated reimbursement rates for D5986 across 13 states, sourced from CMS Transparency in Coverage data. 90 rate records.
D5986 designates the Fluoride Gel Carrier, an instrument used to apply fluoride gel during preventive dental treatments. This procedure is clinically indicated for patients requiring topical fluoride application to prevent caries, particularly in high-risk populations. Documentation for billing should include the patient's caries risk assessment, the type of fluoride used, and the specific treatment provided. Reimbursement for this code averages around $93, but it may vary by payor and state, with some insurance plans covering fluoride treatments more comprehensively than others, impacting the overall reimbursement amount.
Reimbursement rates for D5986 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 |
|---|---|
| South Carolina | $127 |
| Nevada | $121 |
| New York | $116 |
| Virginia | $91 |
| Indiana | $90 |
| State | Avg Rate |
|---|---|
| Colorado | $75 |
| Georgia | $75 |
| Connecticut | $74 |
| Michigan | $74 |
| North Carolina | $74 |