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Billing code D3333 · Dental

D3333 Medicaid reimbursement rate by state (2026)

Dental services. Medicaid pays a median of $186.66 for D3333 across 8 states, from $46.28 in Florida to $392.85 in Delaware.

Data as of Oct 5, 20268 statesEvery rate links to its official source

States publishing
8
National median
$186.66units vary by state
Lowest
$46.28Florida
Highest
$392.85Delaware
Answer

What does Medicaid pay for D3333?

8 state Medicaid programs publish a fee-for-service rate for D3333. The national median is $186.66 (units differ between states). Delaware pays the most, $392.85, and Florida the least, $46.28, a 8.5x spread.

State ranking

D3333 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 8 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Delaware Source · since 2026-04-01$392.85——Not classified—
2Missouri Source · since 2022-07-01$322.40——Plans must pay at least this—
3Oregon Source · since 2026-01-01$211.40——Plans negotiate; applies out of network—
7Arizona Source · since 2026-10-01$122.04——Plans negotiate; applies out of network—
8Florida Source · since 2026-07-01$46.28——Plans negotiate; applies out of network—
See all 8 states for D3333 — start free

3 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
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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 D3333 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 D3333, 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. 3 of the 8 states list more than one rate for D3333, 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. None of the 8 schedules prints a separate unit for D3333, so each amount is a flat payment for one service as the code defines it.
  • Per hour. D3333 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 D3333, 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 D3333 rates differ between states

Published rates for D3333 run from $46.28 in Florida to $392.85 in Delaware, a 8.5x gap in the same unit. Half the states pay more than the median of $186.66 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. 5 states set the current rate for D3333 in 2026 or later, while 1 state 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 D3333

Most Medicaid members are in managed-care plans, and plans don't publish their provider fee schedules. For D3333, the public signal is the rule each state sets for its plans, recorded on each rate above.

In 1 state, the published rate binds plans: a floor, a pass-through or a state-set rate. In 3 states, plans negotiate and the published rate is a benchmark or out-of-network default. In 1 state, the service is paid outside the plans or through a state-directed payment. The rule for the remaining 3 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (3 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 (1 state). 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 (1 state). 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 D3333

D3333 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 D3333?

It depends on the state. Of the 8 states with a published fee-for-service rate, the median is $186.66. Delaware pays the most ($392.85) and Florida the least ($46.28).

Which state pays the highest Medicaid rate for D3333?

Delaware, at $392.85, effective 2026-04-01.

Which state pays the lowest Medicaid rate for D3333?

Florida, at $46.28, effective 2026-07-01.

What unit is D3333 billed in?

None of the 8 schedules prints a separate unit for D3333, so each amount is a flat payment for one service as the code defines it.

Do managed-care plans pay the same rate for D3333?

Not necessarily. In 1 state, the published rate binds plans: a floor, a pass-through or a state-set rate. In 3 states, plans negotiate and the published rate is a benchmark or out-of-network default. In 1 state, the service is paid outside the plans or through a state-directed payment. The rule for the remaining 3 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.