D5936 Medicaid reimbursement rates by state
Dental services. 7 state Medicaid programs publish a fee-for-service rate for D5936 at the physician psychologist level. Rates run from $40.00 in California to $1,673.55 in Utah, with a median of $700.35.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 7
- Median rate
- $700.35units vary by state
- Highest
- $1,673.55Utah
- Medicare (non-facility)
- —not on the physician fee schedule
D5936 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 |
|---|---|---|---|---|---|---|
| UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan) | $1,673.55since 2019-10-01 | — | — | Plans must pay at least this | — | Utah Medicaid Coverage and Reimbursement |
| ColoradoAny qualified provider (rate does not vary by provider) · Colorado HCBS waiver for persons with developmental disabilities (DD) | $1,576.19since 2026-07-01 | — | — | Paid by the state, outside plans | — | HCBS-DD and SLS Waiver Dental Services f |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $838.44since 2024-01-01 | — | — | Plans must pay at least this | — | SoonerCare Dental Fee Schedule |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $700.35since 2025-03-01 | — | — | Plans must pay at least this | — | MO HealthNet fee schedule: Dental |
| TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP) | $597.19since 2025-09-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Denta |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $591.93since 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 |
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 D5936?
It depends on the state. Of the 7 states with a published fee-for-service rate, the median is $700.35. Utah pays the most ($1,673.55) and California the least ($40.00 per percent of SMA).
Which state pays the highest Medicaid rate for D5936?
Utah, at $1,673.55, effective 2019-10-01.
Do managed-care plans pay the same rate for D5936?
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.