D0474 Medicaid reimbursement rates by state
Dental services. 8 state Medicaid programs publish a fee-for-service rate for D0474. Rates run from $8.92 in Kansas to $288.00 in Oregon, with a median of $74.89.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 8
- Median rate
- $74.89units vary by state
- Highest
- $288.00Oregon
- Medicare (non-facility)
- —not on the physician fee schedule
D0474 rate in every state
One like-for-like fee-for-service rate per state, highest first. Units can differ between states; the per-hour column converts time-based units.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $288.00⚠ over 3× mediansince 2025-01-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $152.38since 2021-01-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid Dental fee schedule (2021Den |
| New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service) | $87.87since 2023-01-01 | — | — | Plans negotiate; applies out of network | — | eMedNY NYS Medicaid Dental Fee Schedule |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $77.03since 2025-04-21 | — | — | Plans must pay at least this | — | Louisiana Medicaid Dental Program Fee Sc |
| West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services) | $72.75since 2026-04-01 | — | — | Plans negotiate; applies out of network | — | BMS 2026 Dental Fee Schedule Effective 4 |
| NevadaAny qualified provider (rate does not vary by provider) · Nevada HCBS Waiver for Individuals with Intellectual and Developmental Disabilities (provider type 38, fee-for-service) | $56.83since 2024-01-01 | — | — | Paid by the state, outside plans | — | Provider Type 22 Dentist Reimbursement S |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $48.40since 2026-07-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $8.92since 2000-01-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
Rates marked ⚠ are more than three times the median for the same unit; they are published as shown but often reflect an office (non-facility) fee or a different scope of service. Rates are per the unit shown for each state; units can differ between states. Medicare amounts are computed from the CMS relative value file and locality cost indices with the CMS formula; states with several Medicare localities show a range. Confirm rates with the payer before billing.
Frequently asked questions
What does Medicaid pay for D0474?
It depends on the state. Of the 8 states with a published fee-for-service rate, the median is $74.89. Oregon pays the most ($288.00) and Kansas the least ($8.92).
Which state pays the highest Medicaid rate for D0474?
Oregon, at $288.00, effective 2025-01-01.
Do managed-care plans pay the same rate for D0474?
Not necessarily. Each state's plan contracts decide whether plans must pay at least the fee-for-service rate, pay a state-set rate, or negotiate their own. The table shows the rule for each state, cited to the contract or statute.