D3352 Medicaid reimbursement rate by state (2026)
Dental services. Medicaid pays a median of $107.25 for D3352 across 38 states, from $14.10 in Illinois to $286.90 in Delaware.
- States publishing
- 38
- National median
- $107.25units vary by state
- Lowest
- $14.10Illinois
- Highest
- $286.90Delaware
What does Medicaid pay for D3352?
38 state Medicaid programs publish a fee-for-service rate for D3352. The national median is $107.25 (units differ between states). Delaware pays the most, $286.90, and Illinois the least, $14.10, a 20.3x spread.
D3352 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 38 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 D3352, 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. 14 of the 38 states list more than one rate for D3352, 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 38 states, 1 publish D3352 per unit and 1 per percent of sma, and 36 schedules print no unit at all (a flat amount per service).
- Per hour. D3352 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 D3352, 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 D3352 rates differ between states
Published rates for D3352 run from $14.10 in Illinois to $286.90 in Delaware, a 20.3x gap in the same unit. Half the states pay more than the median of $107.25 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. 10 states set the current rate for D3352 in 2026 or later, while 10 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 D3352
No managed-care plan publishes what it pays for D3352. 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 9 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 10 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 9 states is not classified yet.
- 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.
- Plans negotiate; the published rate applies out of network (10 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 (9 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.
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.
Units and billing for D3352
D3352 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.
Frequently asked questions
What does Medicaid pay for D3352?
It depends on the state. Of the 38 states with a published fee-for-service rate, the median is $107.25. Delaware pays the most ($286.90) and Illinois the least ($14.10).
Which state pays the highest Medicaid rate for D3352?
Delaware, at $286.90, effective 2026-04-01.
Which state pays the lowest Medicaid rate for D3352?
Illinois, at $14.10, effective 2015-07-01.
What unit is D3352 billed in?
Of the 38 states, 1 publish D3352 per unit and 1 per percent of sma, and 36 schedules print no unit at all (a flat amount per service).
Do managed-care plans pay the same rate for D3352?
Not necessarily. In 9 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 10 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 9 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.