D4263 Medicaid reimbursement rates by state
Dental services. 15 state Medicaid programs publish a fee-for-service rate for D4263 at the physician psychologist level. Rates run from $25.00 in Kansas to $707.26 in Delaware, with a median of $319.01.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 15
- Median rate
- $319.01units vary by state
- Highest
- $707.26Delaware
- Medicare (non-facility)
- —not on the physician fee schedule
D4263 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 |
|---|---|---|---|---|---|---|
| DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP) | $707.26since 2026-04-01 | — | — | Not classified | — | DMAP 2026 Dental Fee Schedule |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $600.00since 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) | $520.47since 2026-07-01 | — | — | Paid by the state, outside plans | — | HCBS-DD and SLS Waiver Dental Services f |
| VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA) | $453.75since 2023-07-01 | — | — | Not classified | — | Vermont Medicaid Fee Schedule - HCPCS (i |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $424.47since 2025-07-01 | — | — | Not classified | — | MaineCare Fee Schedule (MaineCare UCR, H |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $414.97since 2023-01-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid Dental fee schedule (2023Den |
| District of ColumbiaAny qualified provider (rate does not vary by provider) · DC Medicaid (DHCF) fee-for-service | $361.00since 2006-01-07 | — | — | Not classified | — | REFRP00179CSV - Dental Fee Schedule Repo |
| WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health) | $319.01since 2023-04-01 | — | — | Not classified | — | Wyoming Medicaid Downloadable Fee Schedu |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $315.81since 2026-07-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $277.63since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Dental r |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $218.00since 2010-10-01 | — | — | Paid by the state, outside plans | — | DMAS procedure fee file dental.csv |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $204.49since 2024-01-01 | — | — | Plans must pay at least this | — | Provider Type 20 Physician, MD., Osteopa |
| IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $174.52since 2013-07-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #14 CLINIC (C |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $141.15since 2015-07-01 | — | — | Plans negotiate; applies out of network | — | HFS [[' HFS Dental Program Fee Schedule |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $25.00since 1996-01-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
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 D4263?
It depends on the state. Of the 15 states with a published fee-for-service rate, the median is $319.01. Delaware pays the most ($707.26) and Kansas the least ($25.00).
Which state pays the highest Medicaid rate for D4263?
Delaware, at $707.26, effective 2026-04-01.
Do managed-care plans pay the same rate for D4263?
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.