Negotiated reimbursement rates for D6985 across 13 states, sourced from CMS Transparency in Coverage data. 95 rate records.
D6985 is the code for a pediatric partial denture that is fixed. This procedure is indicated for children who require a fixed prosthesis to replace missing teeth, often due to congenital issues or trauma. Proper documentation is essential and should include the child's dental history, the rationale for the fixed partial denture, and any relevant clinical findings. Reimbursement for D6985 can vary by payor and state, with some plans offering better coverage for pediatric dental services. The average reimbursement for this procedure is around $370.
Reimbursement rates for D6985 vary significantly by state, payor, and provider network. The national average negotiated rate is $370. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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| State | Avg Rate |
|---|---|
| Colorado | $825 |
| Hawaii | $658 |
| Texas | $658 |
| South Carolina | $530 |
| Washington | $511 |
| State | Avg Rate |
|---|---|
| California | $468 |
| Maryland | $426 |
| Indiana | $386 |
| New York | $117 |
| Connecticut | $82 |