D1701 Medicaid reimbursement rate by state (2026)
Dental services. Medicaid pays a median of $42.21 for D1701 across 7 states, from $16.05 in Oregon to $90.00 in Indiana.
- States publishing
- 7
- National median
- $42.21units vary by state
- Lowest
- $16.05Oregon
- Highest
- $90.00Indiana
What does Medicaid pay for D1701?
7 state Medicaid programs publish a fee-for-service rate for D1701. The national median is $42.21 (units differ between states). Indiana pays the most, $90.00 per percent of billed charges, and Oregon the least, $16.05, a 5.6x spread.
D1701 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 7 states with every variant, modifier and effective date.
How to read this table
- Order. States are listed from the highest published rate to the lowest. No single unit is shared by 8 or more states for D1701, so the order is by published amount and is not a like-for-like rank.
- Medicaid rate. The most the state's fee-for-service program pays for one unit, as published. 2 of the 7 states list more than one rate for D1701, by modifier, provider type or setting; the table shows the one that matches the provider level and setting used across states, without add-ons.
- Unit. Of the 7 states, 1 publish D1701 per percent of billed charges, and 6 schedules print no unit at all (a flat amount per service).
- Per hour. D1701 is not billed in time units in these states, so no hourly figure is shown.
- Managed-care plans. The rule the state sets for its plans on this rate. What each rule means is explained below.
- % of Medicare. No Medicare physician fee schedule amount is on file for D1701, so there is no percentage.
- Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.
Why D1701 rates differ between states
Published rates for D1701 run from $16.05 in Oregon to $90.00 in Indiana. The two publish it in different units (percent of billed charges versus no unit printed), so part of that gap is the unit rather than the price. Half the states pay more than the median of $42.21 and half pay less. The usual reasons for a spread like this in dental rates:
- Federal rules require dental coverage for children through EPSDT, while adult dental benefits are optional and range from emergency-only to comprehensive.
- Many states run dental through a dental benefit administrator, and fee updates are often infrequent compared with medical schedules.
- Some states publish separate child and adult fees for the same procedure, or pay specialists more than general dentists.
Timing matters too. 3 states set the current rate for D1701 in 2026 or later, while 2 states still pay a rate that took effect in 2022 or earlier. A state that has not updated its rate in years will drift down the ranking as others raise theirs.
What managed-care plans pay for D1701
What a plan pays for D1701 is negotiated privately, but the state decides how much room there is to negotiate. Here is how the rules break down across the 7 states.
In 3 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 2 states, plans negotiate and the published rate is a benchmark or out-of-network default. In 2 states, the service is paid outside the plans or through a state-directed payment.
- Plans must pay at least the published rate (3 states). The published rate is your floor. Negotiate up from it, and if a plan pays less, the contract provision is the basis for a payment dispute.
- Paid by the state, outside the plans (2 states). Bill the state's Medicaid program, not the plan, at the published rate. There is no plan contract to negotiate for this service.
- Plans negotiate; the published rate applies out of network (2 states). In-network rates can be above or below the published rate. The published rate is the benchmark both sides know, and the fallback if no contract is signed.
Plan-negotiated rates are never estimated here. To see the rule and its citation for a particular state, open that state's managed-care page, for example Indiana managed care.
Units and billing for D1701
D1701 is a CDT dental code in the dental line, billed mostly by general dentists, pediatric dentists, oral surgeons and dental clinics. CDT codes are maintained by the American Dental Association. Each is paid once per procedure, with the tooth number and surfaces on the claim, and many states publish separate child and adult amounts.
Frequency limits, such as how often an exam or cleaning is covered, decide whether a service is paid at all, regardless of the fee. Dental codes (CDT, maintained by the American Dental Association) are paid once per procedure, with the tooth number and surfaces on the claim.
Before billing, confirm the rate, unit and any modifier with the state's current schedule or the plan: the amounts here are as published, not a guarantee of payment.
Frequently asked questions
What does Medicaid pay for D1701?
It depends on the state. Of the 7 states with a published fee-for-service rate, the median is $42.21. Indiana pays the most ($90.00 per percent of billed charges) and Oregon the least ($16.05).
Which state pays the highest Medicaid rate for D1701?
Indiana, at $90.00 per percent of billed charges, effective 2022-01-01.
Which state pays the lowest Medicaid rate for D1701?
Oregon, at $16.05, effective 2026-01-01. It publishes the code in a different unit from Indiana, so compare per unit with care.
What unit is D1701 billed in?
Of the 7 states, 1 publish D1701 per percent of billed charges, and 6 schedules print no unit at all (a flat amount per service).
Do managed-care plans pay the same rate for D1701?
Not necessarily. In 3 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 2 states, plans negotiate and the published rate is a benchmark or out-of-network default. In 2 states, the service is paid outside the plans or through a state-directed payment. Each rule is cited to the plan contract, statute or notice in the workspace.