D5925 Medicaid reimbursement rates by state
Dental services. 5 state Medicaid programs publish a fee-for-service rate for D5925. Rates run from $40.00 in California to $951.83 in Colorado, with a median of $704.28.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 5
- Median rate
- $704.28units vary by state
- Highest
- $951.83Colorado
- Medicare (non-facility)
- —not on the physician fee schedule
D5925 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) | $951.83since 2026-07-01 | — | — | Paid by the state, outside plans | — | HCBS-DD and SLS Waiver Dental Services f |
| West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services) | $717.00since 2026-04-01 | — | — | Plans negotiate; applies out of network | — | BMS 2026 Dental Fee Schedule Effective 4 |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $704.28since 2022-01-01 | — | — | Paid by the state, outside plans | — | ForwardHealth max fee schedule: Dental ( |
| TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP) | $358.31since 2018-09-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Denta |
| 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 |
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 D5925?
It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $704.28. Colorado pays the most ($951.83) and California the least ($40.00 per percent of SMA).
Which state pays the highest Medicaid rate for D5925?
Colorado, at $951.83, effective 2026-07-01.
Do managed-care plans pay the same rate for D5925?
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.