Hawaii Medicaid Dental Fee Schedule
Hawaii Medicaid pays dentists about $45.84 for an adult cleaning, $104.58 for a one-surface filling, and $73.02 for a simple extraction under the 2026 dental fee schedule. Hawaii ranks #33 of 51 states and DC on our common-procedure basket (below the national median).
The table below covers common procedures. The Rates plan unlocks every code on the Hawaii fee schedule, plus CSV export and alerts when rates change.
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Key Medicaid dental rates
Does Hawaii Medicaid cover dental for adults?
Hawaii's published Medicaid dental fee schedule lists reimbursement rates for adult procedures, including cleanings, fillings, and extractions, which means Hawaii Medicaid pays for these when they are provided to adult members. Pediatric dental is federally mandated under EPSDT; adult dental is an optional benefit each state funds on its own, so covered procedures and annual limits vary. The rates below are what Medicaid pays when a service is reimbursed, not a statement of eligibility. Confirm current adult coverage with the Hawaii Medicaid program.
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What Hawaii Medicaid pays per procedure
A fixed basket of the procedures patients and dentists search for most. Rates are the representative amount across Hawaii's published schedules.
| Code | Procedure | Medicaid rate |
|---|---|---|
| D0120 | Periodic oral exam | $29.85 |
| D1110 | Adult cleaning | $45.84 |
| D1120 | Child cleaningPediatric | $31.15 |
| D2391 | 1-surface composite filling | $104.58 |
| D2930 | Stainless steel crown (primary tooth)Pediatric | $130.59 |
| D7140 | Simple extraction | $73.02 |
Schedule covers 169 CDT procedure codes (2026 rates). “Not covered” means the procedure is not listed in the published fee schedule.
Get this fee schedule by email
Take Hawaii’s fee schedule with you
We’ll email you the common-procedure Medicaid rates as a CSV: exams, cleanings, fillings, crowns, extractions, and more. No login, no spam.
Hawaii Medicaid dental schedules
Hawaii publishes 10 distinct dental fee schedules. Each covers a different population or provider tier.
162 codes
162 codes
160 codes
160 codes
158 codes
158 codes
158 codes
158 codes
154 codes
154 codes
Common questions
How much does Hawaii Medicaid pay for dental?
Hawaii Medicaid pays about $45.84 for an adult cleaning, $104.58 for a one-surface filling, and $73.02 for a simple extraction under the 2026 dental fee schedule. It ranks #33 of 51 jurisdictions on a basket of common procedures (below the national median). These are fee-for-service rates; Medicaid managed-care plan rates differ.
What does Hawaii Medicaid pay for a dental cleaning?
Hawaii Medicaid pays $45.84 for an adult cleaning (D1110) and $31.15 for a child cleaning (D1120).
Does Hawaii Medicaid cover dental for adults?
Hawaii's Medicaid fee schedule lists rates for adult dental procedures, including an adult cleaning at $45.84 and a 1-surface filling at $104.58. A listed rate is what Medicaid pays when a service is reimbursed, not a statement of adult eligibility; confirm current coverage with the state program.
What is the Hawaii Medicaid rate for a dental crown?
Hawaii Medicaid pays $130.59 for a stainless steel crown on a primary tooth (D2930), the standard crown billed under pediatric Medicaid dental.
How does Hawaii Medicaid dental reimbursement compare to other states?
On a fixed basket of common procedures (exam, adult and child cleaning, filling, crown, extraction), Hawaii ranks #33 of 51 jurisdictions, below the national median for dental Medicaid reimbursement.
When was the Hawaii Medicaid dental fee schedule last updated?
The Hawaii Medicaid dental rates on this page reflect the 2026 published fee schedule. ProviderSignal refreshes state Medicaid schedules on the cadence each program publishes, typically quarterly or annually.
Compare Hawaii by procedure
See how Hawaii compares to every state on what Medicaid pays for a single procedure.
Methodology
Rates are pulled from Hawaii’s published Medicaid dental fee schedule, a public record. The national rank uses a fixed basket of six common procedures (periodic exam, adult and child cleaning, 1-surface filling, stainless steel crown, simple extraction) so every state is compared on the same procedures rather than on a raw average that code mix would distort. Where a state publishes separate adult and pediatric schedules, both are shown. 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.
Who uses this data
Fee schedules are one slice of a larger dental market dataset. The same government sources power territory and acquisition intelligence for the teams that work with dental practices every day.
Territory trigger feeds, license expiration alerts, and practice profiles for reps who sell into dental offices.
DSO acquisition teamsDSO affiliation mapping and practice-level signals for buy-side sourcing.
Practice brokersRetirement-age and license signals for finding practices likely to transition.
Our data sourcesEvery dataset behind these numbers: NPPES, state dental boards, Medicaid fee schedules, CMS, and OIG exclusions.