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D4910 Medicaid reimbursement rates by state

Dental services. 38 state Medicaid programs publish a fee-for-service rate for D4910 at the physician psychologist level. Rates run from $27.00 in Rhode Island to $155.49 in Delaware, with a median of $63.05.

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

States publishing
38
Median rate
$63.05units vary by state
Highest
$155.49Delaware
Medicare (non-facility)
—not on the physician fee schedule

D4910 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
DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP)$155.49since 2026-04-01——Not classified—DMAP 2026 Dental Fee Schedule
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$138.00since 2024-01-01——Not classified—CMAP fee schedule: 10/1/2026 Adult Denta
ColoradoAny qualified provider (rate does not vary by provider) · Colorado HCBS waiver for persons with developmental disabilities (DD)$129.33since 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)$125.60since 2022-07-01——Plans must pay at least this—MO HealthNet fee schedule: Dental
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$108.75since 2023-07-01——Not classified—Vermont Medicaid Fee Schedule - HCPCS (i
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$108.41since 2026-01-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$106.22since 2025-07-01——Not classified—MaineCare Fee Schedule (MaineCare UCR, H
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$105.29since 2026-01-01——Plans must pay at least this—MDHHS Dental Fee Schedule database, Janu
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$102.03since 2024-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$96.88since 2023-01-01——Plans negotiate; applies out of network—KY Medicaid Dental fee schedule (2023Den
HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service dental$91.20since 2025-04-01——Paid by the state, outside plans—Med-QUEST Children and Adult Dental Fee
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$89.22since 2025-01-01——Plans must pay at least this—Utah Medicaid Coverage and Reimbursement
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$88.94since 2026-08-10——Not classified—Arkansas Medicaid Dental Fee Schedule (R
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$84.07since 2023-10-01——Paid by the state, outside plans—2026 Fee Schedule - Covered Procedures R
MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service)$79.04since 2025-07-01——Not classified—Montana Healthcare Programs fee schedule
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$67.07since 2024-01-01——Plans negotiate; applies out of network—Appendix DD to OAC 5160-1-60 (ODM workbo
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$67.00since 2015-07-01——Plans negotiate; applies out of network—HFS [[' HFS Dental Program Fee Schedule
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$66.40since 2025-10-01——Not classified—Dental Fee Schedule (REF-0128-Q)
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$64.00since 2026-04-01——Plans negotiate; applies out of network—BMS 2026 Dental Fee Schedule Effective 4
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$62.09since 2010-10-01——Paid by the state, outside plans—DMAS procedure fee file dental.csv
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$60.98since 2024-01-01——Plans must pay at least this—SoonerCare 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)$59.84since 2018-07-01——Plans must pay at least this—Iowa Medicaid fee schedule #14 CLINIC (C
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$57.99since 2022-01-01——Paid by the state, outside plans—ForwardHealth max fee schedule: Dental (
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$57.84since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Dental Codes fee sch
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$57.42since 2026-07-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Dental r
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$56.94since 2025-07-01——Paid by the state, outside plans—HCA Dental fee schedule (dental-20250701
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal Dental (fee-for-service, Schedule of Maximum Allowances)$55.00since 2018-05-16——Paid by the state, outside plans—Medi-Cal Dental Schedule of Maximum Allo
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$54.55since 2025-10-01——Paid by the state, outside plans—NC Medicaid fee schedule 'Federally Qual
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid dental (Maryland Healthy Smiles, fee-for-service through the dental ASO)$54.00since 2023-08-01——Paid by the state, outside plans—2026 CDT Fee Schedule - Section 508 Comp
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$52.11since 2025-07-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$45.45since 2023-01-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid Dental Fee Schedule
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$43.26since 2026-10-01——Plans negotiate; applies out of network—Part II Policies and Procedures for Dent
NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$43.04since 2024-01-01——Plans must pay at least this—Provider Type 20 Physician, MD., Osteopa
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$39.23since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$38.72since 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)$35.83since 2025-09-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Denta
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$35.69since 2000-08-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service)$27.00since 1993-04-01——Paid by the state, outside plans—RI Medicaid Interactive Fee For Service

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 D4910?

It depends on the state. Of the 38 states with a published fee-for-service rate, the median is $63.05. Delaware pays the most ($155.49) and Rhode Island the least ($27.00).

Which state pays the highest Medicaid rate for D4910?

Delaware, at $155.49, effective 2026-04-01.

Do managed-care plans pay the same rate for D4910?

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 D4910 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
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