Negotiated reimbursement rates for D5995 across 11 states, sourced from CMS Transparency in Coverage data. 117 rate records.
D5995 pertains to the creation of a lab-processed periodontal medicament carrier, which is used to deliver medications directly to periodontal tissues. This procedure is indicated for patients with periodontal disease requiring localized treatment. Documentation must include the type of medicament used, the patient's periodontal status, and the intended outcomes. Average reimbursement for this procedure is approximately $434, but it can vary by payor and state, with some insurance plans covering it under different categories, affecting overall reimbursement rates.
Reimbursement rates for D5995 vary significantly by state, payor, and provider network. The national average negotiated rate is $434. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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| State | Avg Rate |
|---|---|
| Maryland | $484 |
| South Carolina | $484 |
| Texas | $484 |
| California | $482 |
| Georgia | $477 |
| State | Avg Rate |
|---|---|
| Vermont | $408 |
| Arizona | $308 |
| New Mexico | $211 |
| Nevada | $142 |
| Utah | $137 |