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D4267 Medicaid reimbursement rates by state

Dental services. 6 state Medicaid programs publish a fee-for-service rate for D4267 at the physician psychologist level. Rates run from $310.54 in Texas to $692.29 in Kentucky, with a median of $449.42.

Data as of 2026-10-05. Every rate links to the official document it came from.

States publishing
6
Median rate
$449.42units vary by state
Highest
$692.29Kentucky
Medicare (non-facility)
—not on the physician fee schedule

D4267 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.

StateMedicaid rateUnitPer hourManaged-care plans% of MedicareSource
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$692.29since 2023-01-01——Plans negotiate; applies out of network—KY Medicaid Dental fee schedule (2023Den
ColoradoAny qualified provider (rate does not vary by provider) · Colorado HCBS waiver for persons with developmental disabilities (DD)$682.26since 2026-07-01——Paid by the state, outside plans—HCBS-DD and SLS Waiver Dental Services f
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$554.44since 2023-01-01——Plans must pay at least this—MO HealthNet fee schedule: Dental
NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$344.39since 2024-01-01——Plans must pay at least this—Provider Type 20 Physician, MD., Osteopa
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$336.16since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Dental r
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$310.54since 2025-09-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Denta

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 D4267?

It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $449.42. Kentucky pays the most ($692.29) and Texas the least ($310.54).

Which state pays the highest Medicaid rate for D4267?

Kentucky, at $692.29, effective 2023-01-01.

Do managed-care plans pay the same rate for D4267?

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.

Related Dental codes

Track D4267 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
Medicaid rates by state