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Billing code D5660 · Dental

D5660 Medicaid reimbursement rate by state (2026)

Dental services. Medicaid pays a median of $119.00 for D5660 across 41 states, from $40.00 in California to $305.47 in Delaware.

Data as of Oct 5, 202641 statesEvery rate links to its official source

States publishing
41
National median
$119.00units vary by state
Lowest
$40.00California
Highest
$305.47Delaware
Answer

What does Medicaid pay for D5660?

41 state Medicaid programs publish a fee-for-service rate for D5660. The national median is $119.00 (units differ between states). Delaware pays the most, $305.47, and California the least, $40.00 per percent of SMA, a 7.6x spread.

State ranking

D5660 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 41 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Delaware Source · since 2026-04-01$305.47——Not classified—
2Missouri Source · since 2022-07-01$245.60——Plans must pay at least this—
3Colorado Source · since 2026-07-01$229.81——Paid by the state, outside plans—
20New Mexico Source · since 2025-01-01$120.42——Plans must pay at least this—
21Louisiana Source · since 2025-04-21$119.00——Plans must pay at least this—
22Maine Source · since 2025-07-01$118.82——Not classified—
40Florida Source · since 2026-07-01$52.23——Plans negotiate; applies out of network—
41California Source · since 2018-07-01$40.00percent of SMA—Paid by the state, outside plans—
See all 41 states for D5660 — start free

33 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 D5660 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 D5660, 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. 22 of the 41 states list more than one rate for D5660, 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 41 states, 1 publish D5660 per unit and 1 per percent of sma, and 39 schedules print no unit at all (a flat amount per service).
  • Per hour. D5660 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 D5660, 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 D5660 rates differ between states

Published rates for D5660 run from $40.00 in California to $305.47 in Delaware. The two publish it in different units (no unit printed versus percent of SMA), so part of that gap is the unit rather than the price. Half the states pay more than the median of $119.00 and half pay less. The usual reasons for a spread like this in dental rates:

  • Some states publish separate child and adult fees for the same procedure, or pay specialists more than general dentists.
  • 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.

Timing matters too. 12 states set the current rate for D5660 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.

Managed care

What managed-care plans pay for D5660

No managed-care plan publishes what it pays for D5660. 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 10 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 11 states is not classified yet.

  • Plans must pay at least the published rate (10 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.
  • 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.

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 D5660

D5660 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.

Frequency limits, such as how often an exam or cleaning is covered, decide whether a service is paid at all, regardless of the fee. Dental codes (CDT, maintained by the American Dental Association) are paid once per procedure, with the tooth number and surfaces on the claim.

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 D5660?

It depends on the state. Of the 41 states with a published fee-for-service rate, the median is $119.00. Delaware pays the most ($305.47) and California the least ($40.00 per percent of SMA).

Which state pays the highest Medicaid rate for D5660?

Delaware, at $305.47, effective 2026-04-01.

Which state pays the lowest Medicaid rate for D5660?

California, at $40.00 per percent of SMA, effective 2018-07-01. It publishes the code in a different unit from Delaware, so compare per unit with care.

What unit is D5660 billed in?

Of the 41 states, 1 publish D5660 per unit and 1 per percent of sma, and 39 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for D5660?

Not necessarily. In 10 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 11 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.