D4261 Medicaid reimbursement rate by state (2026)
Dental services. Medicaid pays a median of $375.14 for D4261 across 24 states, from $40.00 in California to $1,025.81 in Delaware.
- States publishing
- 24
- National median
- $375.14units vary by state
- Lowest
- $40.00California
- Highest
- $1,025.81Delaware
What does Medicaid pay for D4261?
24 state Medicaid programs publish a fee-for-service rate for D4261. The national median is $375.14 (units differ between states). Delaware pays the most, $1,025.81, and California the least, $40.00 per percent of SMA, a 25.6x spread.
D4261 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 24 states with every variant, modifier and effective date.
Frequently asked questions
What does Medicaid pay for D4261?
It depends on the state. Of the 24 states with a published fee-for-service rate, the median is $375.14. Delaware pays the most ($1,025.81) and California the least ($40.00 per percent of SMA).
Which state pays the highest Medicaid rate for D4261?
Delaware, at $1,025.81, effective 2026-04-01.
Do managed-care plans pay the same rate for D4261?
Not necessarily. Each state's plan contracts decide whether plans must pay at least the fee-for-service rate, pay a state-set rate, or negotiate their own. The workspace shows the rule for each state, cited to the contract or statute.