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Billing code D2976 · Dental

D2976 Medicaid reimbursement rate by state (2026)

Dental services. Medicaid pays a median of $61.19 for D2976 across 6 states, from $20.00 in Ohio to $90.00 in Indiana.

Data as of Oct 5, 20266 statesEvery rate links to its official source

States publishing
6
National median
$61.19units vary by state
Lowest
$20.00Ohio
Highest
$90.00Indiana
Answer

What does Medicaid pay for D2976?

6 state Medicaid programs publish a fee-for-service rate for D2976. The national median is $61.19 (units differ between states). Indiana pays the most, $90.00 per percent of billed charges, and Ohio the least, $20.00, a 4.5x spread.

State ranking

D2976 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 6 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Indiana Source · since 2024-01-01$90.00percent of billed charges—Plans must pay at least this—
2West Virginia Source · since 2026-04-01$80.00——Plans negotiate; applies out of network—
3Oklahoma Source · since 2024-01-01$67.08——Plans must pay at least this—
6Ohio Source · since 2024-01-01$20.00——Plans negotiate; applies out of network—
See all 6 states for D2976 — start free

2 more states, with every modifier and provider-type variant, rate history and the plan rule in each state. 14-day free trial, no credit card.

  • Source for every rate
  • Full rate history
  • CSV and API export

Rates are per the unit shown for each state; units can differ between states. Medicare amounts are computed from the CMS relative value file and locality cost indices; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Track D2976 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
Guide

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 D2976, 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 6 states list more than one rate for D2976, 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 6 states, 1 publish D2976 per percent of billed charges, and 5 schedules print no unit at all (a flat amount per service).
  • Per hour. D2976 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 D2976, 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.
Context

Why D2976 rates differ between states

Published rates for D2976 run from $20.00 in Ohio 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 $61.19 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. 2 states set the current rate for D2976 in 2026 or later. A state that has not updated its rate in years will drift down the ranking as others raise theirs.

Managed care

What managed-care plans pay for D2976

Most Medicaid members are in managed-care plans, and plans don't publish their provider fee schedules. For D2976, the public signal is the rule each state sets for its plans, recorded on each rate above.

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. The rule for the remaining 1 state is not classified yet.

  • 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.
  • 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.

Billing

Units and billing for D2976

D2976 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.

Dental codes (CDT, maintained by the American Dental Association) are paid once per procedure, with the tooth number and surfaces on the claim. Frequency limits, such as how often an exam or cleaning is covered, decide whether a service is paid at all, regardless of the fee.

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.

FAQ

Frequently asked questions

What does Medicaid pay for D2976?

It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $61.19. Indiana pays the most ($90.00 per percent of billed charges) and Ohio the least ($20.00).

Which state pays the highest Medicaid rate for D2976?

Indiana, at $90.00 per percent of billed charges, effective 2024-01-01.

Which state pays the lowest Medicaid rate for D2976?

Ohio, at $20.00, effective 2024-01-01. It publishes the code in a different unit from Indiana, so compare per unit with care.

What unit is D2976 billed in?

Of the 6 states, 1 publish D2976 per percent of billed charges, and 5 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for D2976?

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. The rule for the remaining 1 state is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.