D5731 Medicaid reimbursement rates by state
Dental services. 34 state Medicaid programs publish a fee-for-service rate for D5731 at the physician psychologist level. Rates run from $31.46 in New Jersey to $432.75 in Delaware, with a median of $153.56.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 34
- Median rate
- $153.56units vary by state
- Highest
- $432.75Delaware
- Medicare (non-facility)
- —not on the physician fee schedule
D5731 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 |
|---|---|---|---|---|---|---|
| DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP) | $432.75since 2026-04-01 | — | — | Not classified | — | DMAP 2026 Dental Fee Schedule |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $339.20since 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) | $307.44since 2026-07-01 | — | — | Paid by the state, outside plans | — | HCBS-DD and SLS Waiver Dental Services f |
| District of ColumbiaAny qualified provider (rate does not vary by provider) · DC Medicaid (DHCF) fee-for-service | $279.13since 2025-10-01 | — | — | Not classified | — | REFRP00179CSV - Dental Fee Schedule Repo |
| North DakotaAny qualified provider (rate does not vary by provider) · North Dakota Medicaid (fee-for-service) | $253.89since 2026-07-01 | — | — | Not classified | — | ND Medicaid Dental Services Fee Schedule |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $244.57since 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) | $243.86since 2026-08-10 | — | — | Not classified | — | Arkansas Medicaid Dental Fee Schedule (R |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $243.05since 2007-10-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services) | $238.00since 2026-07-01 | — | — | Not classified | — | South Dakota Medicaid Adult Dental Servi |
| MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service) | $237.12since 2025-07-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| AlaskaAny qualified provider (rate does not vary by provider) · Alaska Medicaid (fee-for-service, Department of Health) | $229.05since 2025-07-01 | — | — | Not classified | — | Alaska Medicaid Dental Fee Schedule SFY2 |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $202.39since 2010-10-01 | — | — | Paid by the state, outside plans | — | DMAS procedure fee file dental.csv |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $183.83since 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) | $182.81since 2023-04-01 | — | — | Not classified | — | Wyoming Medicaid Downloadable Fee Schedu |
| Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service) | $173.00since 2022-07-01 | — | — | Paid by the state, outside plans | — | RI Medicaid Interactive Fee For Service |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $171.03since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Dental r |
| HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service dental | $158.22since 2024-04-01 | — | — | Paid by the state, outside plans | — | Med-QUEST Children and Adult Dental Fee |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $148.90since 2025-07-01 | — | — | Not classified | — | MaineCare Fee Schedule (MaineCare UCR, H |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $144.77since 2025-10-01 | — | — | Paid by the state, outside plans | — | NC Medicaid fee schedule 'Federally Qual |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $137.96since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $131.61since 2024-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $129.15since 2024-01-01 | — | — | Plans must pay at least this | — | Provider Type 20 Physician, MD., Osteopa |
| New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service) | $126.25since 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) | $109.69since 2013-07-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #14 CLINIC (C |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $107.80since 2016-09-01 | — | — | Not classified | — | CMAP fee schedule: 10/1/2026 Pediatric D |
| West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services) | $93.87since 2026-04-01 | — | — | Plans negotiate; applies out of network | — | BMS 2026 Dental Fee Schedule Effective 4 |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $89.77since 2000-08-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $88.40since 2023-10-01 | — | — | Paid by the state, outside plans | — | 2026 Fee Schedule - Covered Procedures R |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $88.00since 2023-01-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid Dental fee schedule (2023Den |
| TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP) | $77.64since 2025-09-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Denta |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $70.60since 2015-07-01 | — | — | Plans negotiate; applies out of network | — | HFS [[' HFS Dental Program Fee Schedule |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal Dental (fee-for-service, Schedule of Maximum Allowances) | $70.00since 2021-10-01 | — | — | Paid by the state, outside plans | — | Medi-Cal Dental Schedule of Maximum Allo |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $63.28since 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) | $31.46since 2026-07-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
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 D5731?
It depends on the state. Of the 34 states with a published fee-for-service rate, the median is $153.56. Delaware pays the most ($432.75) and New Jersey the least ($31.46).
Which state pays the highest Medicaid rate for D5731?
Delaware, at $432.75, effective 2026-04-01.
Do managed-care plans pay the same rate for D5731?
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
D7140Dental services · 47 statesD7210Dental services · 47 statesD7220Dental services · 47 statesD7230Dental services · 47 statesD7240Dental services · 47 statesD0120Dental services · 47 statesD0150Dental services · 47 statesD1110Dental services · 47 statesD1120Dental services · 47 statesD1351Dental services · 47 statesD1510Dental services · 47 statesD2330Dental services · 47 states
Track D5731 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.