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D7472 Medicaid reimbursement rates by state

Dental services. 20 state Medicaid programs publish a fee-for-service rate for D7472. Rates run from $40.00 in California to $925.05 in Michigan, with a median of $245.21.

Data as of 2026-10-05. Every rate links to the official document it came from.

States publishing
20
Median rate
$245.21units vary by state
Highest
$925.05Michigan
Medicare (non-facility)
—not on the physician fee schedule

D7472 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.

StateMedicaid rateUnitPer hourManaged-care plans% of MedicareSource
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$925.05⚠ over 3× mediansince 2026-01-01——Plans must pay at least this—MDHHS Dental Fee Schedule database, Janu
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$653.62since 2024-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
ColoradoAny qualified provider (rate does not vary by provider) · Colorado HCBS waiver for persons with developmental disabilities (DD)$606.55since 2026-07-01——Paid by the state, outside plans—HCBS-DD and SLS Waiver Dental Services f
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$509.60since 2016-09-01——Not classified—CMAP fee schedule: 10/1/2026 Pediatric D
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$452.63since 2022-01-01——Paid by the state, outside plans—ForwardHealth max fee schedule: Dental (
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$373.00since 2026-01-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$343.00since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Dental r
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$302.47since 2026-01-01——Plans negotiate; applies out of network—KY Medicaid Dental fee schedule (2026Den
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$279.55since 2025-10-01——Paid by the state, outside plans—NC Medicaid fee schedule 'Federally Qual
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$245.40since 2010-10-01——Paid by the state, outside plans—DMAS procedure fee file dental.csv
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$245.01since 2025-03-01——Plans must pay at least this—MO HealthNet fee schedule: Dental
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$242.70since 2024-01-01——Plans negotiate; applies out of network—Appendix DD to OAC 5160-1-60 (ODM workbo
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$213.76since 2026-07-01——Plans negotiate; applies out of network—HFS [[' HFS Dental Program Fee Schedule
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$176.16since 2026-07-01——Plans negotiate; applies out of network—Dental General Fee Schedule (AHCA Update
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$154.73since 2025-07-01——Paid by the state, outside plans—HCA Dental fee schedule (dental-20250701
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$152.88since 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)$118.58since 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)$116.67since 2019-01-01——Plans must pay at least this—Iowa Medicaid fee schedule #14 CLINIC (C
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid dental (Maryland Healthy Smiles, fee-for-service through the dental ASO)$105.00since 2023-08-01——Paid by the state, outside plans—2026 CDT Fee Schedule - Section 508 Comp
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal Dental Proposition 56 supplemental payments$40.00since 2018-07-01percent of SMA—Paid by the state, outside plans—CDT Codes and SMAs for Proposition 56 Su

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 D7472?

It depends on the state. Of the 20 states with a published fee-for-service rate, the median is $245.21. Michigan pays the most ($925.05) and California the least ($40.00 per percent of SMA).

Which state pays the highest Medicaid rate for D7472?

Michigan, at $925.05, effective 2026-01-01.

Do managed-care plans pay the same rate for D7472?

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

Track D7472 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
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