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D4274 Medicaid reimbursement rates by state

Dental services. 6 state Medicaid programs publish a fee-for-service rate for D4274. Rates run from $70.60 in Illinois to $618.40 in Missouri, with a median of $257.46.

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

States publishing
6
Median rate
$257.46units vary by state
Highest
$618.40Missouri
Medicare (non-facility)
—not on the physician fee schedule

D4274 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
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$618.40since 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)$409.17since 2026-07-01——Paid by the state, outside plans—HCBS-DD and SLS Waiver Dental Services f
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$329.79since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Dental r
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$185.13since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$119.44since 2025-09-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Denta
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$70.60since 2015-07-01——Plans negotiate; applies out of network—HFS [[' HFS Dental Program Fee Schedule

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 D4274?

It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $257.46. Missouri pays the most ($618.40) and Illinois the least ($70.60).

Which state pays the highest Medicaid rate for D4274?

Missouri, at $618.40, effective 2022-07-01.

Do managed-care plans pay the same rate for D4274?

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 D4274 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
Medicaid rates by state