Wisconsin Medicaid Dental Fee Schedule
What Wisconsin Medicaid pays dentists for common procedures. Wisconsin ranks #2 of 51 states and DC by our common-procedure basket (top quartile).
Key Medicaid dental rates
What Wisconsin Medicaid pays per procedure
A fixed basket of the procedures patients and dentists search for most. Rates are the representative amount across Wisconsin's published schedule.
| Code | Procedure | Medicaid rate |
|---|---|---|
| D0120 | Periodic oral exam | $45.51 |
| D1110 | Adult cleaning | $37.69 |
| D1120 | Child cleaningPediatric | $62.55 |
| D2391 | 1-surface composite filling | $160.47 |
| D2930 | Stainless steel crown (primary tooth)Pediatric | $264.42 |
| D7140 | Simple extraction | $139.41 |
Schedule covers 282 CDT procedure codes (2026 rates). “Not covered” means the procedure is not listed in the published fee schedule.
Common questions
What does Wisconsin Medicaid pay for a dental cleaning?
Wisconsin Medicaid pays $37.69 for an adult cleaning (D1110) and $62.55 for a child cleaning (D1120).
What does Wisconsin Medicaid pay for adult dental?
Wisconsin's Medicaid fee schedule lists rates for adult dental procedures, including an adult cleaning at $37.69 and a 1-surface filling at $160.47. 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 Wisconsin Medicaid rate for a dental crown?
Wisconsin Medicaid pays $264.42 for a stainless steel crown on a primary tooth (D2930), the standard crown billed under pediatric Medicaid dental.
How does Wisconsin Medicaid dental reimbursement compare to other states?
On a fixed basket of common procedures (exam, adult and child cleaning, filling, crown, extraction), Wisconsin ranks #2 of 51 jurisdictions, top quartile for dental Medicaid reimbursement.
When was the Wisconsin Medicaid dental fee schedule last updated?
The Wisconsin 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.
Methodology
Rates are pulled from Wisconsin’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.