D4245 Medicaid reimbursement rates by state
Dental services. 7 state Medicaid programs publish a fee-for-service rate for D4245. Rates run from $38.12 in New Jersey to $756.80 in Missouri, with a median of $313.10.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 7
- Median rate
- $313.10units vary by state
- Highest
- $756.80Missouri
- Medicare (non-facility)
- —not on the physician fee schedule
D4245 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 |
|---|---|---|---|---|---|---|
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $756.80since 2022-07-01 | — | — | Plans must pay at least this | — | MO HealthNet fee schedule: Dental |
| ColoradoAny qualified provider (rate does not vary by provider) · Colorado HCBS waiver for persons with developmental disabilities (DD) | $448.97since 2026-07-01 | — | — | Paid by the state, outside plans | — | HCBS-DD and SLS Waiver Dental Services f |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $344.69since 2025-07-01 | — | — | Not classified | — | MaineCare Fee Schedule (MaineCare UCR, H |
| IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $313.10since 2014-04-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #04 DENTIST ( |
| TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP) | $173.19since 2018-09-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Denta |
| New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service) | $126.25since 2023-01-01 | — | — | Plans negotiate; applies out of network | — | eMedNY NYS Medicaid Dental Fee Schedule |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $38.12since 2026-07-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
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 D4245?
It depends on the state. Of the 7 states with a published fee-for-service rate, the median is $313.10. Missouri pays the most ($756.80) and New Jersey the least ($38.12).
Which state pays the highest Medicaid rate for D4245?
Missouri, at $756.80, effective 2022-07-01.
Do managed-care plans pay the same rate for D4245?
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.