D6545 Medicaid reimbursement rates by state
Dental services. 13 state Medicaid programs publish a fee-for-service rate for D6545. Rates run from $90.75 in New Jersey to $788.00 in Missouri, with a median of $289.64.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 13
- Median rate
- $289.64units vary by state
- Highest
- $788.00Missouri
- Medicare (non-facility)
- —not on the physician fee schedule
D6545 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 |
|---|---|---|---|---|---|---|
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $788.00since 2022-07-01 | — | — | Plans must pay at least this | — | MO HealthNet fee schedule: Dental |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $667.34since 2025-04-21 | — | — | Plans must pay at least this | — | Louisiana Medicaid Dental Program Fee Sc |
| ColoradoAny qualified provider (rate does not vary by provider) · Colorado HCBS waiver for persons with developmental disabilities (DD) | $654.70since 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) | $438.00since 2023-07-01 | — | — | Not classified | — | Vermont Medicaid Fee Schedule - HCPCS (i |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $328.77since 2025-07-01 | — | — | Not classified | — | MaineCare Fee Schedule (MaineCare UCR, H |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $293.56since 2010-10-01 | — | — | Paid by the state, outside plans | — | DMAS procedure fee file dental.csv |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $289.64since 2024-01-01 | — | — | Plans must pay at least this | — | SoonerCare Dental Fee Schedule |
| TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP) | $257.40since 2025-09-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Denta |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $203.08since 2022-01-01 | — | — | Paid by the state, outside plans | — | ForwardHealth max fee schedule: Dental ( |
| New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service) | $146.45since 2023-01-01 | — | — | Plans negotiate; applies out of network | — | eMedNY NYS Medicaid Dental Fee Schedule |
| West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services) | $119.68since 2026-04-01 | — | — | Plans negotiate; applies out of network | — | BMS 2026 Dental Fee Schedule Effective 4 |
| IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $99.72since 2013-07-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #14 CLINIC (C |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $90.75since 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 D6545?
It depends on the state. Of the 13 states with a published fee-for-service rate, the median is $289.64. Missouri pays the most ($788.00) and New Jersey the least ($90.75).
Which state pays the highest Medicaid rate for D6545?
Missouri, at $788.00, effective 2022-07-01.
Do managed-care plans pay the same rate for D6545?
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.