D7854 Medicaid reimbursement rates by state
Dental services. 6 state Medicaid programs publish a fee-for-service rate for D7854 at the physician psychologist level. Rates run from $40.00 in California to $4,310.45 in Colorado, with a median of $535.66.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 6
- Median rate
- $535.66units vary by state
- Highest
- $4,310.45Colorado
- Medicare (non-facility)
- —not on the physician fee schedule
D7854 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) | $4,310.45⚠ over 3× mediansince 2024-07-01 | — | — | Paid by the state, outside plans | — | Appendix H: DIDD and Medicaid Dental Rat |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $2,538.16⚠ over 3× mediansince 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Dental r |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $602.69since 2024-01-01 | — | — | Plans must pay at least this | — | Provider Type 20 Physician, MD., Osteopa |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $468.62since 2022-01-01 | — | — | Paid by the state, outside plans | — | ForwardHealth max fee schedule: Dental ( |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $209.33since 2026-07-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| 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 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 D7854?
It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $535.66. Colorado pays the most ($4,310.45) and California the least ($40.00 per percent of SMA).
Which state pays the highest Medicaid rate for D7854?
Colorado, at $4,310.45, effective 2024-07-01.
Do managed-care plans pay the same rate for D7854?
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.