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D5212 Medicaid reimbursement rates by state

Dental services. 32 state Medicaid programs publish a fee-for-service rate for D5212 at the physician psychologist level. Rates run from $165.73 in Florida to $1,272.80 in Missouri, with a median of $472.50.

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

States publishing
32
Median rate
$472.50units vary by state
Highest
$1,272.80Missouri
Medicare (non-facility)
—not on the physician fee schedule

D5212 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)$1,272.80since 2022-07-01——Plans must pay at least this—MO HealthNet fee schedule: Dental
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$950.60since 2016-09-01——Not classified—CMAP fee schedule: 10/1/2026 Pediatric D
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$928.30since 2025-07-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$806.86since 2026-01-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$795.36since 2025-04-21——Plans must pay at least this—Louisiana Medicaid Dental Program Fee Sc
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$767.86since 2026-01-01——Plans must pay at least this—MDHHS Dental Fee Schedule database, Janu
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$700.00since 2024-07-01——Paid by the state, outside plans—SCDHHS Dental Fee Schedule (Schedule upd
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$684.51since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus dental fee schedu
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$668.27since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Dental r
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$665.44since 2014-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$660.65since 2010-10-01——Paid by the state, outside plans—DMAS procedure fee file dental.csv
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$627.64since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$595.80since 2023-01-01——Plans negotiate; applies out of network—KY Medicaid Dental fee schedule (2023Den
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$539.65since 2024-01-01——Plans must pay at least this—SoonerCare Dental Fee Schedule
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$538.30since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Dental Codes fee sch
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$482.23since 2022-01-01——Paid by the state, outside plans—ForwardHealth max fee schedule: Dental (
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$462.76since 2025-10-01——Paid by the state, outside plans—NC Medicaid fee schedule 'Federally Qual
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$441.56since 2024-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$380.96since 2000-08-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
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
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$353.50since 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)$324.10since 2013-07-01——Plans must pay at least this—Iowa Medicaid fee schedule #14 CLINIC (C
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$312.14since 2025-07-01——Paid by the state, outside plans—HCA Dental fee schedule (dental-20250701
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$302.50since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$283.56since 2026-10-01——Plans negotiate; applies out of network—Part II Policies and Procedures for Dent
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$262.76since 2025-09-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Denta
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal Dental (fee-for-service, Schedule of Maximum Allowances)$250.00since 2019-07-10——Paid by the state, outside plans—Medi-Cal Dental Schedule of Maximum Allo
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid dental (Maryland Healthy Smiles, fee-for-service through the dental ASO)$225.00since 2023-08-01——Paid by the state, outside plans—2026 CDT Fee Schedule - Section 508 Comp
NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$215.25since 2024-01-01——Plans must pay at least this—Provider Type 20 Physician, MD., Osteopa
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$205.00since 2008-07-01——Plans negotiate; applies out of network—ODM Dental CDT Procedures, effective 04/
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$185.00since 2026-07-14——Not classified—Arkansas Medicaid Dental Fee Schedule (R
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$165.73since 2026-07-01——Plans negotiate; applies out of network—Dental General Fee Schedule (AHCA Update

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 D5212?

It depends on the state. Of the 32 states with a published fee-for-service rate, the median is $472.50. Missouri pays the most ($1,272.80) and Florida the least ($165.73).

Which state pays the highest Medicaid rate for D5212?

Missouri, at $1,272.80, effective 2022-07-01.

Do managed-care plans pay the same rate for D5212?

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 D5212 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
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