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D5284 Medicaid reimbursement rates by state

Dental services. 7 state Medicaid programs publish a fee-for-service rate for D5284. Rates run from $90.00 in Indiana to $960.00 in Missouri, with a median of $408.55.

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

States publishing
7
Median rate
$408.55units vary by state
Highest
$960.00Missouri
Medicare (non-facility)
—not on the physician fee schedule

D5284 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)$960.00since 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)$803.53since 2026-07-01——Paid by the state, outside plans—HCBS-DD and SLS Waiver Dental Services f
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$743.08since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Dental r
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$408.55since 2024-01-01——Plans must pay at least this—SoonerCare Dental Fee Schedule
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$400.00since 2022-01-01——Plans negotiate; applies out of network—KY Medicaid Dental fee schedule (2022Den
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$184.29since 2020-01-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$90.00since 2020-01-01percent 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 D5284?

It depends on the state. Of the 7 states with a published fee-for-service rate, the median is $408.55. Missouri pays the most ($960.00) and Indiana the least ($90.00 per percent of billed charges).

Which state pays the highest Medicaid rate for D5284?

Missouri, at $960.00, effective 2022-07-01.

Do managed-care plans pay the same rate for D5284?

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 D5284 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
Medicaid rates by state