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Billing code D4264 · Dental

D4264 Medicaid reimbursement rate by state (2026)

Dental services. Medicaid pays a median of $238.45 for D4264 across 13 states, from $10.00 in Kansas to $600.62 in Delaware.

Data as of Oct 5, 202613 statesEvery rate links to its official source

States publishing
13
National median
$238.45units vary by state
Lowest
$10.00Kansas
Highest
$600.62Delaware
Answer

What does Medicaid pay for D4264?

13 state Medicaid programs publish a fee-for-service rate for D4264. The national median is $238.45 (units differ between states). Delaware pays the most, $600.62, and Kansas the least, $10.00, a 60.1x spread.

State ranking

D4264 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 13 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Delaware Source · since 2026-04-01$600.62——Not classified—
2Missouri Source · since 2022-07-01$492.80——Plans must pay at least this—
3Colorado Source · since 2026-07-01$381.80——Paid by the state, outside plans—
6District of Columbia Source · since 2006-01-07$271.00——Not classified—
7Arizona Source · since 2026-10-01$238.45——Plans negotiate; applies out of network—
8Iowa Source · since 2013-07-01$174.52——Plans must pay at least this—
12Illinois Source · since 2015-07-01$70.60——Plans negotiate; applies out of network—
13Kansas Source · since 1996-01-01$10.00——Not classified—
See all 13 states for D4264 — start free

5 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 D4264 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
FAQ

Frequently asked questions

What does Medicaid pay for D4264?

It depends on the state. Of the 13 states with a published fee-for-service rate, the median is $238.45. Delaware pays the most ($600.62) and Kansas the least ($10.00).

Which state pays the highest Medicaid rate for D4264?

Delaware, at $600.62, effective 2026-04-01.

Do managed-care plans pay the same rate for D4264?

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.