Dental Medicaid rates by code

The dental line groups the codes billed mostly by general dentists, pediatric dentists, oral surgeons and dental clinics. Across the 51 state programs we cover, 590 codes in this line have a published fee-for-service rate in five or more states. By code set, the line is made up of 590 CDT dental codes.

How to read the index

• Code opens the code's page: every state's rate ranked, the unit, a per-hour figure for timed codes, the managed-care rule and a Medicare comparison where the units match.
• States is the number of state Medicaid programs that publish a fee-for-service rate for the code. A higher count makes the median more representative.
• Median rate is the middle published amount across those states, in the units they use. When states publish a code in different units, the median mixes them, so open the code before relying on it.

Why dental rates differ between states

• Federal rules require dental coverage for children through EPSDT, while adult dental benefits are optional and range from emergency-only to comprehensive.
• Many states run dental through a dental benefit administrator, and fee updates are often infrequent compared with medical schedules.
• Some states publish separate child and adult fees for the same procedure, or pay specialists more than general dentists.

Billing and units

Dental codes (CDT, maintained by the American Dental Association) are paid once per procedure, with the tooth number and surfaces on the claim. Frequency limits, such as how often an exam or cleaning is covered, decide whether a service is paid at all, regardless of the fee.