Pennsylvania Medicaid Dental Fee Schedule
Pennsylvania Medicaid pays dentists about $36.00 for an adult cleaning, $50.00 for a one-surface filling, and $65.00 for a simple extraction under the 2025 dental fee schedule. Pennsylvania ranks #48 of 51 states and DC on our common-procedure basket (bottom quartile).
The Rates plan
$29/mo7-day free trialThe table below shows common procedures. The full Pennsylvania schedule covers 171 codes.
- Every code on all 51 published schedules
- Full-schedule CSV export
- Full state Medicaid dental network lists
- Email alerts when a state changes its rates
$29/mo after the trial. Cancel anytime.
Key Medicaid dental rates
Pennsylvania’s Medicaid program lists 1,810 enrolled dental providers on its published roster. Enrollment means the state lists the provider as participating; call the office to confirm they are accepting new Medicaid patients.
Looking for a dentist who takes Pennsylvania Medicaid? Browse state-listed Pennsylvania Medicaid dentists by city and plan.
Billing medical, not dental? Pennsylvania's Medicaid fee-schedule hub covers what the state publishes across physician, DME, labs, behavioral health, and more.
Does Pennsylvania Medicaid cover dental for adults?
Pennsylvania's published Medicaid dental fee schedule lists reimbursement rates for adult procedures, including cleanings, fillings, and extractions, which means Pennsylvania 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 Pennsylvania Medicaid program.
What Pennsylvania Medicaid pays per procedure
A fixed basket of the procedures patients and dentists search for most. Rates are the representative amount across Pennsylvania's published schedule.
| Code | Procedure | Medicaid rate |
|---|---|---|
| D0120 | Periodic oral exam | $20.00 |
| D1110 | Adult cleaning | $36.00 |
| D1120 | Child cleaningPediatric | $30.00 |
| D2391 | 1-surface composite filling | $50.00 |
| D2930 | Stainless steel crown (primary tooth)Pediatric | $99.00 |
| D7140 | Simple extraction | $65.00 |
| D5110 | Complete dentures | Rate available on the Rates plan |
| D7220 | Wisdom teeth removal | Rate available on the Rates plan |
| D7210 | Surgical tooth extraction | Rate available on the Rates plan |
165 more codes are on the full Pennsylvania schedule. See every code for $29 a month | ||
Schedule covers 171 CDT procedure codes (2025 rates). “Not covered” means the procedure is not listed in the published fee schedule. Checked against Pennsylvania’s published schedule on August 14, 2026.
Recent rate changes
- D9224Adjunctive services (PA MA Dental FFS):added at $156.002026-08-15
- D9225Adjunctive services (PA MA Dental FFS):added at $156.002026-08-15
- D9244Adjunctive services (PA MA Dental FFS):added at $111.002026-08-15
- D9245Adjunctive services (PA MA Dental FFS):added at $111.002026-08-15
- D9246Adjunctive services (PA MA Dental FFS):added at $123.002026-08-15
- D9247Adjunctive services (PA MA Dental FFS):added at $101.002026-08-15
Alerts when Pennsylvania changes its rates come with the Rates plan, along with the complete schedule as CSV.
Common questions
How much does Pennsylvania Medicaid pay for dental?
Pennsylvania Medicaid pays about $36.00 for an adult cleaning, $50.00 for a one-surface filling, and $65.00 for a simple extraction under the 2025 dental fee schedule. It ranks #48 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 Pennsylvania Medicaid pay for a dental cleaning?
Pennsylvania Medicaid pays $36.00 for an adult cleaning (D1110) and $30.00 for a child cleaning (D1120).
Does Pennsylvania Medicaid cover dental for adults?
Pennsylvania's Medicaid fee schedule lists rates for adult dental procedures, including an adult cleaning at $36.00 and a 1-surface filling at $50.00. 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 Pennsylvania Medicaid rate for a dental crown?
Pennsylvania Medicaid pays $99.00 for a stainless steel crown on a primary tooth (D2930), the standard crown billed under pediatric Medicaid dental.
How does Pennsylvania Medicaid dental reimbursement compare to other states?
On a fixed basket of common procedures (exam, adult and child cleaning, filling, crown, extraction), Pennsylvania ranks #48 of 51 jurisdictions, bottom quartile for dental Medicaid reimbursement.
When was the Pennsylvania Medicaid dental fee schedule last updated?
The Pennsylvania 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.
How much does Pennsylvania Medicaid pay for a tooth extraction?
Pennsylvania Medicaid's published fee schedule pays about $65.00 for a tooth extraction (CDT D7140) under the 2025 schedule. That is the fee-for-service amount paid to the dentist; it is not a coverage guarantee, and adult coverage rules differ by state. Confirm coverage for your age group and plan with the state Medicaid program.
How much does Pennsylvania Medicaid pay for complete dentures?
Pennsylvania Medicaid's published fee schedule pays about $525.00 for complete dentures (CDT D5110 family) under the 2025 schedule. That is the fee-for-service amount paid to the dentist; it is not a coverage guarantee, and adult coverage rules differ by state. Confirm coverage for your age group and plan with the state Medicaid program.
How much does Pennsylvania Medicaid pay for wisdom teeth removal?
Pennsylvania Medicaid's published fee schedule pays about $90.00 for wisdom teeth removal (CDT D7220 family) under the 2025 schedule. That is the fee-for-service amount paid to the dentist; it is not a coverage guarantee, and adult coverage rules differ by state. Confirm coverage for your age group and plan with the state Medicaid program.
Compare Pennsylvania by procedure
What Pennsylvania pays for each common procedure, with every state’s comparison one click away. Each rate shown is the median across Pennsylvania’s localities for the first of the procedure’s CDT codes the state lists.
Methodology
Rates are pulled from Pennsylvania’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.