D5227 Medicaid reimbursement rates by state
Dental services. 7 state Medicaid programs publish a fee-for-service rate for D5227. Rates run from $90.00 in Indiana to $1,387.78 in Colorado, with a median of $526.23.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 7
- Median rate
- $526.23units vary by state
- Highest
- $1,387.78Colorado
- Medicare (non-facility)
- —not on the physician fee schedule
D5227 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 |
|---|---|---|---|---|---|---|
| ColoradoAny qualified provider (rate does not vary by provider) · Colorado HCBS waiver for persons with developmental disabilities (DD) | $1,387.78since 2026-07-01 | — | — | Paid by the state, outside plans | — | HCBS-DD and SLS Waiver Dental Services f |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $823.25since 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) | $740.00since 2023-10-01 | — | — | Paid by the state, outside plans | — | 2026 Fee Schedule - Covered Procedures R |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $526.23since 2023-01-01 | — | — | Paid by the state, outside plans | — | ForwardHealth max fee schedule: Dental ( |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $480.25since 2022-01-01 | — | — | Plans must pay at least this | — | MO HealthNet fee schedule: Dental |
| NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $322.88since 2024-01-01 | — | — | Plans negotiate; applies out of network | — | Provider Type 22 Dentist Reimbursement S |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $90.00since 2023-09-15 | percent of billed charges | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
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 D5227?
It depends on the state. Of the 7 states with a published fee-for-service rate, the median is $526.23. Colorado pays the most ($1,387.78) and Indiana the least ($90.00 per percent of billed charges).
Which state pays the highest Medicaid rate for D5227?
Colorado, at $1,387.78, effective 2026-07-01.
Do managed-care plans pay the same rate for D5227?
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.