Tennessee Medicaid Dental Fee Schedule
What Tennessee Medicaid pays dentists for common procedures. Tennessee ranks #34 of 51 states and DC by our common-procedure basket (below the national median).
Key Medicaid dental rates
What Tennessee Medicaid pays per procedure
A fixed basket of the procedures patients and dentists search for most. Tennessee publishes separate adult and pediatric schedules, shown side by side below.
| Code | Procedure | Adult | Pediatric |
|---|---|---|---|
| D0120 | Periodic oral exam | $26.11 | $29.24 |
| D1110 | Adult cleaning | $45.63 | $51.11 |
| D1120 | Child cleaningPediatric | Not covered | $39.75 |
| D2391 | 1-surface composite filling | $66.62 | $74.61 |
| D2930 | Stainless steel crown (primary tooth)Pediatric | Not covered | $132.80 |
| D7140 | Simple extraction | $70.93 | $85.12 |
Schedule covers 494 CDT procedure codes (2025 rates). “Not covered” means the procedure is not listed in the published fee schedule.
Tennessee Medicaid dental schedules
Tennessee publishes 2 distinct dental fee schedules. Each covers a different population or provider tier.
490 codes
248 codes
Common questions
What does Tennessee Medicaid pay for a dental cleaning?
Tennessee Medicaid pays $48.37 for an adult cleaning (D1110) and $39.75 for a child cleaning (D1120).
What does Tennessee Medicaid pay for adult dental?
Tennessee's Medicaid fee schedule lists rates for adult dental procedures, including an adult cleaning at $48.37 and a 1-surface filling at $70.62. 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 Tennessee Medicaid rate for a dental crown?
Tennessee Medicaid pays $132.80 for a stainless steel crown on a primary tooth (D2930), the standard crown billed under pediatric Medicaid dental.
How does Tennessee Medicaid dental reimbursement compare to other states?
On a fixed basket of common procedures (exam, adult and child cleaning, filling, crown, extraction), Tennessee ranks #34 of 51 jurisdictions, below the national median for dental Medicaid reimbursement.
When was the Tennessee Medicaid dental fee schedule last updated?
The Tennessee 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.
Methodology
Rates are pulled from Tennessee’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.