D5130 Medicaid reimbursement rates by state
Dental services. 34 state Medicaid programs publish a fee-for-service rate for D5130 at the physician psychologist level. Rates run from $40.00 in California to $1,690.40 in Missouri, with a median of $728.86.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 34
- Median rate
- $728.86units vary by state
- Highest
- $1,690.40Missouri
- Medicare (non-facility)
- —not on the physician fee schedule
D5130 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) | $1,690.40since 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) | $1,629.13since 2026-07-01 | — | — | Paid by the state, outside plans | — | HCBS-DD and SLS Waiver Dental Services f |
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services) | $1,316.68since 2026-07-01 | — | — | Not classified | — | South Dakota Medicaid Adult Dental Servi |
| VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA) | $1,251.75since 2023-07-01 | — | — | Not classified | — | Vermont Medicaid Fee Schedule - HCPCS (i |
| North DakotaAny qualified provider (rate does not vary by provider) · North Dakota Medicaid (fee-for-service) | $1,232.44since 2026-07-01 | — | — | Not classified | — | ND Medicaid Dental Services Fee Schedule |
| MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service) | $1,086.80since 2025-07-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $1,033.29since 2026-01-01 | — | — | Plans must pay at least this | — | MDHHS Dental Fee Schedule database, Janu |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $1,015.21since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health) | $975.00since 2023-04-01 | — | — | Not classified | — | Wyoming Medicaid Downloadable Fee Schedu |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $867.26since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Dental r |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $851.12since 2025-01-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Dental Codes fee sch |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $840.00since 2023-10-01 | — | — | Paid by the state, outside plans | — | 2026 Fee Schedule - Covered Procedures R |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $838.44since 2024-01-01 | — | — | Plans must pay at least this | — | SoonerCare Dental Fee Schedule |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $837.66since 2025-04-21 | — | — | Plans must pay at least this | — | Louisiana Medicaid Dental Program Fee Sc |
| UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan) | $782.51since 2019-07-01 | — | — | Plans must pay at least this | — | Utah Medicaid Coverage and Reimbursement |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $778.99since 2025-07-01 | — | — | Not classified | — | MaineCare Fee Schedule (MaineCare UCR, H |
| Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service) | $730.00since 2024-04-01 | — | — | Paid by the state, outside plans | — | RI Medicaid Interactive Fee For Service |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $727.72since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service dental | $723.60since 2024-04-01 | — | — | Paid by the state, outside plans | — | Med-QUEST Children and Adult Dental Fee |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $699.56since 2024-01-01 | — | — | Plans must pay at least this | — | Provider Type 20 Physician, MD., Osteopa |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $676.92since 2025-10-01 | — | — | Paid by the state, outside plans | — | NC Medicaid fee schedule 'Federally Qual |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $674.85since 2010-10-01 | — | — | Paid by the state, outside plans | — | DMAS procedure fee file dental.csv |
| West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services) | $634.69since 2026-04-01 | — | — | Plans negotiate; applies out of network | — | BMS 2026 Dental Fee Schedule Effective 4 |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $583.98since 2024-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $567.97since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Part II Policies and Procedures for Dent |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $567.40since 2023-01-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid Dental fee schedule (2023Den |
| IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $548.51since 2019-07-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #14 CLINIC (C |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $479.56since 2000-08-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $427.13since 2026-07-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $400.00since 2020-01-01 | — | — | Plans negotiate; applies out of network | — | ODM Dental CDT Procedures, effective 04/ |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $376.35since 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) | $370.26since 2025-09-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Denta |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $250.00since 1987-07-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal Dental Proposition 56 supplemental payments | $40.00since 2018-07-01 | percent of SMA | — | Paid by the state, outside plans | — | CDT Codes and SMAs for Proposition 56 Su |
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 D5130?
It depends on the state. Of the 34 states with a published fee-for-service rate, the median is $728.86. Missouri pays the most ($1,690.40) and California the least ($40.00 per percent of SMA).
Which state pays the highest Medicaid rate for D5130?
Missouri, at $1,690.40, effective 2022-07-01.
Do managed-care plans pay the same rate for D5130?
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.
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Track D5130 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.