D4278 Medicaid reimbursement rates by state
Dental services. 11 state Medicaid programs publish a fee-for-service rate for D4278 at the physician psychologist level. Rates run from $29.65 in New Jersey to $672.80 in Missouri, with a median of $250.27.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 11
- Median rate
- $250.27units vary by state
- Highest
- $672.80Missouri
- Medicare (non-facility)
- —not on the physician fee schedule
D4278 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) | $672.80since 2022-07-01 | — | — | Plans must pay at least this | — | MO HealthNet fee schedule: Dental |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $304.89since 2024-01-01 | — | — | Plans must pay at least this | — | SoonerCare Dental Fee Schedule |
| New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service) | $303.00since 2023-01-01 | — | — | Plans negotiate; applies out of network | — | eMedNY NYS Medicaid Dental Fee Schedule |
| IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $286.84since 2013-07-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #04 DENTIST ( |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $286.09since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Child Health Plan Plus dental fee schedu |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $250.27since 2025-01-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Dental Codes fee sch |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $213.74since 2024-01-01 | — | — | Plans must pay at least this | — | Provider Type 20 Physician, MD., Osteopa |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $168.71since 2013-05-01 | — | — | Paid by the state, outside plans | — | DMAS procedure fee file dental.csv |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $70.58since 2015-07-01 | — | — | Plans negotiate; applies out of network | — | HFS [[' HFS Dental Program Fee Schedule |
| TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP) | $65.70since 2025-09-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Denta |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $29.65since 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 D4278?
It depends on the state. Of the 11 states with a published fee-for-service rate, the median is $250.27. Missouri pays the most ($672.80) and New Jersey the least ($29.65).
Which state pays the highest Medicaid rate for D4278?
Missouri, at $672.80, effective 2022-07-01.
Do managed-care plans pay the same rate for D4278?
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.