Negotiated reimbursement rates for D9630 across 22 states, sourced from CMS Transparency in Coverage data. 117 rate records.
D9630 is used for drugs or medicaments that are not otherwise classified. This code is applicable for various medications that may be administered in a dental setting but do not fall under standard categories. Clinical indications for this code can include unique or experimental treatments, or medications that are not commonly used in dentistry. Documentation must include the specific drug administered, its purpose, and any relevant clinical notes. Reimbursement for D9630 can be quite variable, as it depends heavily on the specific drug and the insurance provider's policies. The average reimbursement for this code is approximately $36, but dental billing professionals should be prepared for potential denials or requests for additional documentation, as many payors may have specific criteria for coverage.
Reimbursement rates for D9630 vary significantly by state, payor, and provider network. The national average negotiated rate is $36. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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| State | Avg Rate |
|---|---|
| Arizona | $59 |
| Utah | $59 |
| Nevada | $56 |
| Michigan | $48 |
| Florida | $42 |
| State | Avg Rate |
|---|---|
| Pennsylvania | $22 |
| Indiana | $22 |
| Oklahoma | $19 |
| Alabama | $15 |
| Nebraska | $12 |