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Billing code D5621 · Dental

D5621 Medicaid reimbursement rate by state (2026)

Dental services. Medicaid pays a median of $105.99 for D5621 across 37 states, from $36.30 in New Jersey to $267.20 in Missouri.

Data as of Oct 5, 202637 statesEvery rate links to its official source

States publishing
37
National median
$105.99units vary by state
Lowest
$36.30New Jersey
Highest
$267.20Missouri
Answer

What does Medicaid pay for D5621?

37 state Medicaid programs publish a fee-for-service rate for D5621. The national median is $105.99 (units differ between states). Missouri pays the most, $267.20, and New Jersey the least, $36.30, a 7.4x spread.

State ranking

D5621 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 37 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Missouri Source · since 2022-07-01$267.20——Plans must pay at least this—
2Vermont Source · since 2023-07-01$255.75——Not classified—
3Colorado Source · since 2026-07-01$224.64——Paid by the state, outside plans—
18Utah Source · since 2019-07-01$107.17——Plans must pay at least this—
19Maine Source · since 2025-07-01$105.99——Not classified—
20Rhode Island Source · since 2022-07-01$104.00——Paid by the state, outside plans—
36Connecticut Source · since 2022-07-01$39.00——Not classified—
37New Jersey Source · since 2026-07-01$36.30——Not classified—
See all 37 states for D5621 — start free

29 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 D5621 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 D5621?

It depends on the state. Of the 37 states with a published fee-for-service rate, the median is $105.99. Missouri pays the most ($267.20) and New Jersey the least ($36.30).

Which state pays the highest Medicaid rate for D5621?

Missouri, at $267.20, effective 2022-07-01.

Do managed-care plans pay the same rate for D5621?

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.