Negotiated reimbursement rates for D9430 across 33 states, sourced from CMS Transparency in Coverage data. 181 rate records.
D9430 represents an office visit for observation without any services rendered. This code is often used when a patient requires monitoring after a procedure or when a dentist needs to assess a patient's condition before proceeding with treatment. Proper documentation should include the rationale for the observation and any relevant patient history. Reimbursement for D9430 is generally lower than for other codes, and payor policies may differ significantly, with some insurers not covering this code at all or requiring specific conditions to be met before reimbursement.
Reimbursement rates for D9430 vary significantly by state, payor, and provider network. The national average negotiated rate is $55. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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| State | Avg Rate |
|---|---|
| Oklahoma | $86 |
| New Hampshire | $80 |
| Hawaii | $78 |
| Indiana | $76 |
| Nevada | $71 |
| State | Avg Rate |
|---|---|
| Rhode Island | $32 |
| Tennessee | $30 |
| Nebraska | $26 |
| Iowa | $19 |
| Minnesota | $18 |