Medicaid dental reimbursement

New York Medicaid Dental Fee Schedule

New York Medicaid pays dentists about $45.45 for an adult cleaning, $50.50 for a one-surface filling, and $50.50 for a simple extraction under the 2025 dental fee schedule. New York ranks #43 of 51 states and DC on our common-procedure basket (bottom quartile).

Key Medicaid dental rates

#43
National rank of 51 (common-procedure basket)
$55
Representative rate across the basket
$51
1-surface filling (D2391)
$51
Simple extraction (D7140)

Does New York Medicaid cover dental for adults?

New York's published Medicaid dental fee schedule lists reimbursement rates for adult procedures, including cleanings, fillings, and extractions, which means New York 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 New York Medicaid program.

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What New York Medicaid pays per procedure

A fixed basket of the procedures patients and dentists search for most. Rates are the representative amount across New York's published schedule.

CodeProcedureMedicaid rate
D0120Periodic oral exam$25.25
D1110Adult cleaning$45.45
D1120Child cleaningPediatric$43.43
D23911-surface composite filling$50.50
D2930Stainless steel crown (primary tooth)Pediatric$117.16
D7140Simple extraction$50.50

Schedule covers 325 CDT procedure codes (2025 rates). “Not covered” means the procedure is not listed in the published fee schedule.

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Common questions

How much does New York Medicaid pay for dental?

New York Medicaid pays about $45.45 for an adult cleaning, $50.50 for a one-surface filling, and $50.50 for a simple extraction under the 2025 dental fee schedule. It ranks #43 of 51 jurisdictions on a basket of common procedures (bottom quartile). These are fee-for-service rates; Medicaid managed-care plan rates differ.

What does New York Medicaid pay for a dental cleaning?

New York Medicaid pays $45.45 for an adult cleaning (D1110) and $43.43 for a child cleaning (D1120).

Does New York Medicaid cover dental for adults?

New York's Medicaid fee schedule lists rates for adult dental procedures, including an adult cleaning at $45.45 and a 1-surface filling at $50.50. 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 New York Medicaid rate for a dental crown?

New York Medicaid pays $117.16 for a stainless steel crown on a primary tooth (D2930), the standard crown billed under pediatric Medicaid dental.

How does New York Medicaid dental reimbursement compare to other states?

On a fixed basket of common procedures (exam, adult and child cleaning, filling, crown, extraction), New York ranks #43 of 51 jurisdictions, bottom quartile for dental Medicaid reimbursement.

When was the New York Medicaid dental fee schedule last updated?

The New York Medicaid dental rates on this page reflect the 2025 published fee schedule. ProviderSignal refreshes state Medicaid schedules on the cadence each program publishes, typically quarterly or annually.

Compare New York by procedure

See how New York compares to every state on what Medicaid pays for a single procedure.

Methodology

Rates are pulled from New York’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.