Negotiated reimbursement rates for D8020 across 17 states, sourced from CMS Transparency in Coverage data. 93 rate records.
D8020 refers to Limited Orthodontic treatment for transitional dentition, typically applicable to children who are in the mixed dentition stage. This procedure is indicated when a patient requires limited orthodontic intervention to address specific alignment issues or to prepare for future comprehensive treatment. Documentation for billing should include a detailed treatment plan, clinical notes outlining the need for limited intervention, and any diagnostic records such as photographs or radiographs. Reimbursement for D8020 can vary significantly based on the payor and state, with some insurance plans offering minimal coverage, while others may provide a more substantial reimbursement depending on the necessity and complexity of the case. Average reimbursement for this code is around $2, but it is essential to verify benefits with each specific insurance provider.
Reimbursement rates for D8020 vary significantly by state, payor, and provider network. The national average negotiated rate is $2. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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| State | Avg Rate |
|---|---|
| North Dakota | $5,600 |
| New Hampshire | $4,620 |
| Tennessee | $4,620 |
| Connecticut | $4,580 |
| Massachusetts | $4,400 |
| State | Avg Rate |
|---|---|
| New York | $2,094 |
| Ohio | $1,900 |
| Virginia | $1,540 |
| Nevada | $1,403 |
| Arizona | $1,263 |