Negotiated reimbursement rates for D9246 across 34 states, sourced from CMS Transparency in Coverage data. 318 rate records.
Non-IV Moderate Conscious Sedation — Each Additional 15 min is billed for every additional 15 minutes of sedation beyond the initial period. This code is crucial for lengthy procedures where extended sedation is necessary to ensure patient comfort. Clinical indications include prolonged dental treatments or patients requiring additional time under sedation due to anxiety or medical conditions. Documentation must include the total time of sedation, patient monitoring details, and any adverse reactions. Reimbursement rates can differ significantly by payor and state, with some insurance companies having strict guidelines on the total allowable minutes for sedation.
Reimbursement rates for D9246 vary significantly by state, payor, and provider network. The national average negotiated rate is $105. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
31+ more states available with Pro ↓
| State | Avg Rate |
|---|---|
| New York | $306 |
| Connecticut | $288 |
| Pennsylvania | $274 |
| Massachusetts | $250 |
| New Jersey | $166 |
| State | Avg Rate |
|---|---|
| Idaho | $55 |
| Tennessee | $52 |
| Arizona | $50 |
| Kentucky | $47 |
| Ohio | $39 |