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Billing code D3320 · Dental

D3320 Medicaid reimbursement rate by state (2026)

Dental services. Medicaid pays a median of $464.21 for D3320 across 46 states, from $155.25 in Illinois to $972.83 in Delaware.

Data as of Oct 5, 202646 statesEvery rate links to its official source

States publishing
46
National median
$464.21units vary by state
Lowest
$155.25Illinois
Highest
$972.83Delaware
Answer

What does Medicaid pay for D3320?

46 state Medicaid programs publish a fee-for-service rate for D3320. The national median is $464.21 (units differ between states). Delaware pays the most, $972.83, and Illinois the least, $155.25, a 6.3x spread.

State ranking

D3320 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 46 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Delaware Source · since 2026-04-01$972.83——Not classified—
2South Dakota Source · since 2026-07-01$932.00——Not classified—
3Colorado Source · since 2026-07-01$789.41——Paid by the state, outside plans—
23District of Columbia Source · since 2006-01-07$472.00——Not classified—
24Mississippi Source · since 2014-07-01$456.41——Plans must pay at least this—
25Montana Source · since 2025-07-01$454.48——Not classified—
45New Jersey Source · since 2026-07-01$209.33——Not classified—
46Illinois Source · since 2015-07-01$155.25——Plans negotiate; applies out of network—
See all 46 states for D3320 — start free

38 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.

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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 D3320 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 D3320, 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. 21 of the 46 states list more than one rate for D3320, 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 46 states, 1 publish D3320 per unit, and 45 schedules print no unit at all (a flat amount per service).
  • Per hour. D3320 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 D3320, 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 D3320 rates differ between states

Published rates for D3320 run from $155.25 in Illinois to $972.83 in Delaware, a 6.3x gap in the same unit. Half the states pay more than the median of $464.21 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. 13 states set the current rate for D3320 in 2026 or later, while 14 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.

Managed care

What managed-care plans pay for D3320

No managed-care plan publishes what it pays for D3320. What is public is the rule each state's plan contracts set, and that rule decides how much the published rate matters when you contract with a plan.

In 11 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 12 states, plans negotiate and the published rate is a benchmark or out-of-network default. In 10 states, the service is paid outside the plans or through a state-directed payment. The rule for the remaining 13 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (12 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.
  • Plans must pay at least the published rate (11 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 (10 states). Bill the state's Medicaid program, not the plan, at the published rate. There is no plan contract to negotiate for this service.

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 Delaware managed care.

Billing

Units and billing for D3320

D3320 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 D3320?

It depends on the state. Of the 46 states with a published fee-for-service rate, the median is $464.21. Delaware pays the most ($972.83) and Illinois the least ($155.25).

Which state pays the highest Medicaid rate for D3320?

Delaware, at $972.83, effective 2026-04-01.

Which state pays the lowest Medicaid rate for D3320?

Illinois, at $155.25, effective 2015-07-01.

What unit is D3320 billed in?

Of the 46 states, 1 publish D3320 per unit, and 45 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for D3320?

Not necessarily. In 11 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 12 states, plans negotiate and the published rate is a benchmark or out-of-network default. In 10 states, the service is paid outside the plans or through a state-directed payment. The rule for the remaining 13 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.