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D7961 Medicaid reimbursement rates by state

Dental services. 21 state Medicaid programs publish a fee-for-service rate for D7961. Rates run from $40.00 in California to $313.29 in Colorado, with a median of $147.16.

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

States publishing
21
Median rate
$147.16units vary by state
Highest
$313.29Colorado
Medicare (non-facility)
—not on the physician fee schedule

D7961 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
ColoradoAny qualified provider (rate does not vary by provider) · Colorado HCBS waiver for persons with developmental disabilities (DD)$313.29since 2026-07-01——Paid by the state, outside plans—HCBS-DD and SLS Waiver Dental Services f
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$273.90since 2024-12-12unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$211.21since 2025-04-21——Plans must pay at least this—Louisiana Medicaid Dental Program Fee Sc
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$208.28since 2022-01-01——Paid by the state, outside plans—ForwardHealth max fee schedule: Dental (
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$188.69since 2025-10-01——Paid by the state, outside plans—NC Medicaid fee schedule 'Federally Qual
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$173.90since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Dental r
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$172.90since 2022-07-01——Not classified—CMAP fee schedule: 10/1/2026 Adult Denta
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$168.76since 2026-01-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$167.60since 2023-01-01——Plans negotiate; applies out of network—KY Medicaid Dental fee schedule (2023Den
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$148.00since 2025-10-01——Not classified—Dental Fee Schedule (REF-0128-Q)
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$147.16since 2025-03-01——Plans must pay at least this—MO HealthNet fee schedule: Dental
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$134.32since 2026-10-01——Plans negotiate; applies out of network—Part II Policies and Procedures for Dent
IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$127.94since 2021-01-01——Plans must pay at least this—Iowa Medicaid fee schedule #04 DENTIST (
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$124.44since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$119.13since 2021-01-01——Plans negotiate; applies out of network—ODM Dental CDT Procedures, effective 04/
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$100.33since 2025-09-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Denta
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$97.00since 2021-01-08——Paid by the state, outside plans—HCA Dental fee schedule (dental-20210108
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$77.15since 2021-01-01——Plans negotiate; applies out of network—HFS [[' HFS Dental Program Fee Schedule
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$72.60since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid dental (Maryland Healthy Smiles, fee-for-service through the dental ASO)$63.00since 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 2021-10-01percent 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 D7961?

It depends on the state. Of the 21 states with a published fee-for-service rate, the median is $147.16. Colorado pays the most ($313.29) and California the least ($40.00 per percent of SMA).

Which state pays the highest Medicaid rate for D7961?

Colorado, at $313.29, effective 2026-07-01.

Do managed-care plans pay the same rate for D7961?

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

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