D9996 Medicaid reimbursement rates by state
Dental services. 9 state Medicaid programs publish a fee-for-service rate for D9996. Rates run from $0.00 in California to $120.90 in Colorado, with a median of $20.52.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 9
- Median rate
- $20.52units vary by state
- Highest
- $120.90Colorado
- Medicare (non-facility)
- —not on the physician fee schedule
D9996 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) | $120.90⚠ over 3× mediansince 2026-07-01 | — | — | Paid by the state, outside plans | — | HCBS-DD and SLS Waiver Dental Services f |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $50.00since 2022-10-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid Preventive fee schedule (202 |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $49.33since 2025-01-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $22.00since 2025-10-01 | — | — | Paid by the state, outside plans | — | NC Medicaid fee schedule 'Federally Qual |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $20.52since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Part II Policies and Procedures for Dent |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $14.82since 2019-07-01 | — | — | Plans must pay at least this | — | MO HealthNet fee schedule: Dental |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $14.00since 2023-01-01 | — | — | Paid by the state, outside plans | — | HCA Dental fee schedule (dental-20230101 |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $9.24since 2022-01-01 | — | — | Plans negotiate; applies out of network | — | HFS [[' HFS Dental Program Fee Schedule |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal Dental (fee-for-service, Schedule of Maximum Allowances) | $0.00since 2020-05-16 | — | — | Paid by the state, outside plans | — | Medi-Cal Dental Schedule of Maximum Allo |
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 D9996?
It depends on the state. Of the 9 states with a published fee-for-service rate, the median is $20.52. Colorado pays the most ($120.90) and California the least ($0.00).
Which state pays the highest Medicaid rate for D9996?
Colorado, at $120.90, effective 2026-07-01.
Do managed-care plans pay the same rate for D9996?
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.