Medicaid dental reimbursement

Dental Medicaid Reimbursement by State

What Medicaid pays dentists swings about 5.0x by state. Delaware reimburses the most ($175 across our common-procedure basket), Minnesota the least ($35). Here is where every state lands.

National Medicaid dental snapshot

5.0x
Top-to-bottom reimbursement spread
$175
Highest: Delaware
$35
Lowest: Minnesota
$78
National median basket

Medicaid dental reimbursement, ranked

All 50 states and DC, scored on the same six-procedure basket. The filling column (a 1-surface composite, billed the same at any age) is a concrete anchor. Select a state for its full fee schedule and adult-vs-pediatric breakdown.

RankStateBasket index
1Delaware$175
2Wisconsin$118
3Missouri$117
4South Dakota$112
5District of Columbia$110
6New Hampshire$107
7Oregon$104
8Louisiana$96
9Maryland$95
10Colorado$94
11Maine$92
12Ohio$91
13Michigan$91
14North Dakota$90
15Vermont$86
16Indiana$86
17Alaska$86
18West Virginia$86
19Virginia$85
20Mississippi$84
21Connecticut$83
22Massachusetts$82
23Kansas$82
24Wyoming$82
25New Jersey$79
26South Carolina$78
27Arizona$75
28Montana$75
29Georgia$73
30Texas$73
31Nebraska$73
32Hawaii$69
33Kentucky$67
34Tennessee$66
35North Carolina$66
36Washington$66
37Arkansas$65
38New Mexico$62
39Utah$60
40Nevada$59
41Alabama$58
42New York$55
43Iowa$55
44Oklahoma$54
45Illinois$53
46Rhode Island$52
47Pennsylvania$50
48Florida$47
49Idaho$46
50California$40
51Minnesota$35

Children anchor Medicaid dental

Medicaid dental is built around children. Federal EPSDT rules require every state to cover comprehensive dental for everyone under 21, so pediatric schedules are broad and consistently funded; adult dental carries no such mandate and is an optional benefit each state sets on its own. The clearest sign of that priority: in the 11 states that publish separate adult and pediatric fee schedules, a 1-surface filling pays a child at least as much as an adult in 10 of them. (Cleanings are not comparable this way; the adult and child cleaning codes are different procedures.)

Common questions

Which state Medicaid program pays the most for dental?

Delaware pays the most on a fixed basket of common procedures (an exam, two cleanings, a filling, a crown, and an extraction), with a representative reimbursement of $175. Minnesota pays the least at $35, a roughly 5.0x gap.

How is the state ranking calculated?

Each state is scored on a fixed basket of six common procedures (periodic exam, adult and child cleaning, 1-surface filling, stainless steel crown, simple extraction). A fixed basket compares states on the same procedures rather than on a raw average, which the particular mix of codes a state happens to publish would distort. Rates are the median across a state's published schedules.

Why do Medicaid dental rates vary so much between states?

States set their own Medicaid fee schedules. Pediatric dental is federally mandated everywhere under EPSDT, but adult dental is an optional benefit each state funds independently, and even mandated services are priced at each state's own rates. The result is a roughly fivefold spread between the highest and lowest states for the same work.

Are these the rates a dentist actually receives?

These are the published fee-for-service schedule amounts: what the state Medicaid program pays when a service is reimbursed. They are not a coverage or eligibility guarantee, and they do not reflect rates paid by Medicaid managed-care plans, which contract separately. Confirm current rates and eligibility with the state program.

Methodology

Rates come from each state’s published Medicaid dental fee schedule, all public records. The ranking uses a fixed basket of six common procedures so every state is compared on the same work, not on a raw average that code mix would distort. Where a state publishes separate adult and pediatric schedules, rates are the median across them. These are fee-for-service schedule amounts (what Medicaid pays when a service is reimbursed), not a coverage or eligibility guarantee, and they do not reflect Medicaid managed-care plan rates. Confirm current rates and eligibility with the state Medicaid program.