D5851 Medicaid reimbursement rates by state
Dental services. 26 state Medicaid programs publish a fee-for-service rate for D5851 at the physician psychologist level. Rates run from $22.27 in Minnesota to $249.06 in Delaware, with a median of $64.49.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 26
- Median rate
- $64.49units vary by state
- Highest
- $249.06Delaware
- Medicare (non-facility)
- —not on the physician fee schedule
D5851 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) | $249.06⚠ over 3× mediansince 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) | $190.40since 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) | $171.56since 2026-07-01 | — | — | Paid by the state, outside plans | — | HCBS-DD and SLS Waiver Dental Services f |
| VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA) | $147.75since 2023-07-01 | — | — | Not classified | — | Vermont Medicaid Fee Schedule - HCPCS (i |
| AlaskaAny qualified provider (rate does not vary by provider) · Alaska Medicaid (fee-for-service, Department of Health) | $142.52since 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) | $125.00since 2010-10-01 | — | — | Paid by the state, outside plans | — | DMAS procedure fee file dental.csv |
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services) | $111.30since 2026-01-01 | — | — | Not classified | — | South Dakota Medicaid Adult Dental Servi |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $105.85since 2025-07-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
| MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service) | $102.75since 2025-07-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $87.89since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Dental r |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $81.24since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $79.27since 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) | $70.82since 2025-01-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Dental Codes fee sch |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $58.16since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health) | $48.75since 2023-04-01 | — | — | Not classified | — | Wyoming Medicaid Downloadable Fee Schedu |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $48.73since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Part II Policies and Procedures for Dent |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $43.32since 2024-07-01 | — | — | Paid by the state, outside plans | — | 2026 Fee Schedule - Covered Procedures R |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $43.04since 2024-01-01 | — | — | Plans must pay at least this | — | Provider Type 20 Physician, MD., Osteopa |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal Dental Proposition 56 supplemental payments | $40.00since 2018-07-01 | percent of SMA | — | Paid by the state, outside plans | — | CDT Codes and SMAs for Proposition 56 Su |
| TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP) | $35.83since 2025-09-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Denta |
| 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 |
| IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $29.91since 2013-07-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #14 CLINIC (C |
| West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services) | $26.67since 2026-04-01 | — | — | Plans negotiate; applies out of network | — | BMS 2026 Dental Fee Schedule Effective 4 |
| 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 |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid dental (Maryland Healthy Smiles, fee-for-service through the dental ASO) | $24.00since 2023-08-01 | — | — | Paid by the state, outside plans | — | 2026 CDT Fee Schedule - Section 508 Comp |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $22.27since 2000-01-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
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 D5851?
It depends on the state. Of the 26 states with a published fee-for-service rate, the median is $64.49. Delaware pays the most ($249.06) and Minnesota the least ($22.27).
Which state pays the highest Medicaid rate for D5851?
Delaware, at $249.06, effective 2026-04-01.
Do managed-care plans pay the same rate for D5851?
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.
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Track D5851 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.