D9613 Medicaid reimbursement rates by state
Dental services. 8 state Medicaid programs publish a fee-for-service rate for D9613. Rates run from $19.36 in New Jersey to $210.00 in Connecticut, with a median of $23.90.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 8
- Median rate
- $23.90units vary by state
- Highest
- $210.00Connecticut
- Medicare (non-facility)
- —not on the physician fee schedule
D9613 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 |
|---|---|---|---|---|---|---|
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $210.00⚠ over 3× mediansince 2019-01-01 | — | — | Not classified | — | CMAP fee schedule: 10/1/2026 Adult Denta |
| ColoradoAny qualified provider (rate does not vary by provider) · Colorado HCBS waiver for persons with developmental disabilities (DD) | $49.63since 2026-07-01 | — | — | Paid by the state, outside plans | — | HCBS-DD and SLS Waiver Dental Services f |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $45.22since 2022-01-01 | — | — | Paid by the state, outside plans | — | ForwardHealth max fee schedule: Dental ( |
| UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan) | $24.80since 2019-08-01 | — | — | Plans must pay at least this | — | Utah Medicaid Coverage and Reimbursement |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $23.00since 2025-10-01 | — | — | Paid by the state, outside plans | — | NC Medicaid fee schedule 'Federally Qual |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $20.00since 2019-01-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
| North DakotaAny qualified provider (rate does not vary by provider) · North Dakota Medicaid (fee-for-service) | $19.65since 2026-07-01 | — | — | Not classified | — | ND Medicaid Dental Services Fee Schedule |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $19.36since 2026-07-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
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 D9613?
It depends on the state. Of the 8 states with a published fee-for-service rate, the median is $23.90. Connecticut pays the most ($210.00) and New Jersey the least ($19.36).
Which state pays the highest Medicaid rate for D9613?
Connecticut, at $210.00, effective 2019-01-01.
Do managed-care plans pay the same rate for D9613?
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.