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D5411 Medicaid reimbursement rates by state

Dental services. 22 state Medicaid programs publish a fee-for-service rate for D5411. Rates run from $10.89 in New Jersey to $98.01 in Kansas, with a median of $26.16.

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

States publishing
22
Median rate
$26.16units vary by state
Highest
$98.01Kansas
Medicare (non-facility)
—not on the physician fee schedule

D5411 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
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$98.01⚠ over 3× mediansince 2025-07-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$83.20⚠ over 3× mediansince 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)$81.58⚠ over 3× mediansince 2026-07-01——Paid by the state, outside plans—HCBS-DD and SLS Waiver Dental Services f
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$62.26since 2026-01-01——Plans must pay at least this—MDHHS Dental Fee Schedule database, Janu
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$59.62since 2026-08-10——Not classified—Arkansas Medicaid Dental Fee Schedule (R
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$52.50since 2026-01-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$41.38since 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)$36.59since 2024-01-01——Plans must pay at least this—SoonerCare Dental Fee Schedule
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$33.95since 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)$32.28since 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)$27.06since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$25.25since 2023-01-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid Dental Fee Schedule
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal Dental (fee-for-service, Schedule of Maximum Allowances)$25.00since 2014-06-01——Paid by the state, outside plans—Medi-Cal Dental Schedule of Maximum Allo
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$24.36since 2026-10-01——Plans negotiate; applies out of network—Part II Policies and Procedures for Dent
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$20.17since 2025-07-01——Paid by the state, outside plans—HCA Dental fee schedule (dental-20250701
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid dental (Maryland Healthy Smiles, fee-for-service through the dental ASO)$20.00since 2023-08-01——Paid by the state, outside plans—2026 CDT Fee Schedule - Section 508 Comp
IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$19.94since 2013-07-01——Plans must pay at least this—Iowa Medicaid fee schedule #14 CLINIC (C
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$17.92since 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)$16.31since 2000-08-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$15.40since 2023-01-01——Plans negotiate; applies out of network—KY Medicaid Dental fee schedule (2023Den
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$14.06since 2026-07-01——Plans negotiate; applies out of network—Dental General Fee Schedule (AHCA Update
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$10.89since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS

Rates marked ⚠ are more than three times the median for the same unit; they are published as shown but often reflect an office (non-facility) fee or a different scope of 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 D5411?

It depends on the state. Of the 22 states with a published fee-for-service rate, the median is $26.16. Kansas pays the most ($98.01) and New Jersey the least ($10.89).

Which state pays the highest Medicaid rate for D5411?

Kansas, at $98.01, effective 2025-07-01.

Do managed-care plans pay the same rate for D5411?

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 D5411 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
Medicaid rates by state