Negotiated reimbursement rates for D9942 across 15 states, sourced from CMS Transparency in Coverage data. 117 rate records.
D9942 is the code for the repair or reline of an occlusal guard, which is often necessary when the appliance becomes worn or loses its fit. Clinical indications for this procedure include patient complaints of discomfort or changes in occlusion. Documentation should detail the condition of the guard, the specific repairs made, and any adjustments to the patient's treatment plan. Reimbursement for this service can differ by payor and state, with some insurers covering repairs under dental benefits while others may classify them differently. The average reimbursement for this code is around $100.
Reimbursement rates for D9942 vary significantly by state, payor, and provider network. The national average negotiated rate is $100. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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| State | Avg Rate |
|---|---|
| Nevada | $177 |
| Texas | $124 |
| Kentucky | $110 |
| Virginia | $110 |
| Colorado | $106 |
| State | Avg Rate |
|---|---|
| California | $86 |
| New York | $81 |
| Georgia | $75 |
| Hawaii | $70 |
| Tennessee | $64 |