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Billing code D6722 · Dental

D6722 Medicaid reimbursement rate by state (2026)

Dental services. Medicaid pays a median of $454.68 for D6722 across 12 states, from $115.00 in Kansas to $972.80 in Missouri.

Data as of Oct 5, 202612 statesEvery rate links to its official source

States publishing
12
National median
$454.68units vary by state
Lowest
$115.00Kansas
Highest
$972.80Missouri
Answer

What does Medicaid pay for D6722?

12 state Medicaid programs publish a fee-for-service rate for D6722. The national median is $454.68 (units differ between states). Missouri pays the most, $972.80, and Kansas the least, $115.00, a 8.5x spread.

State ranking

D6722 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 12 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Missouri Source · since 2022-07-01$972.80——Plans must pay at least this—
2Montana Source · since 2025-07-01$671.84——Not classified—
3North Dakota Source · since 2026-07-01$537.27——Not classified—
6Virginia Source · since 2010-10-01$500.00——Paid by the state, outside plans—
7Minnesota Source · since 2000-08-01$409.36——Plans negotiate; applies out of network—
8Rhode Island Source · since 2001-12-01$335.00——Paid by the state, outside plans—
11New Jersey Source · since 2026-07-01$169.40——Not classified—
12Kansas Source · since 1987-07-01$115.00——Not classified—
See all 12 states for D6722 — start free

4 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 D6722 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 D6722, 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. 6 of the 12 states list more than one rate for D6722, 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. None of the 12 schedules prints a separate unit for D6722, so each amount is a flat payment for one service as the code defines it.
  • Per hour. D6722 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 D6722, 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 D6722 rates differ between states

Published rates for D6722 run from $115.00 in Kansas to $972.80 in Missouri, a 8.5x gap in the same unit. Half the states pay more than the median of $454.68 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. 3 states set the current rate for D6722 in 2026 or later, while 6 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 D6722

What a plan pays for D6722 is negotiated privately, but the state decides how much room there is to negotiate. Here is how the rules break down across the 12 states.

In 2 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 3 states, plans negotiate and the published rate is a benchmark or out-of-network default. In 2 states, the service is paid outside the plans or through a state-directed payment. The rule for the remaining 5 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (3 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 (2 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 (2 states). Bill the state's Medicaid program, not the plan, at the published rate. There is no plan contract to negotiate for this service.

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 Missouri managed care.

Billing

Units and billing for D6722

D6722 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.

FAQ

Frequently asked questions

What does Medicaid pay for D6722?

It depends on the state. Of the 12 states with a published fee-for-service rate, the median is $454.68. Missouri pays the most ($972.80) and Kansas the least ($115.00).

Which state pays the highest Medicaid rate for D6722?

Missouri, at $972.80, effective 2022-07-01.

Which state pays the lowest Medicaid rate for D6722?

Kansas, at $115.00, effective 1987-07-01.

What unit is D6722 billed in?

None of the 12 schedules prints a separate unit for D6722, so each amount is a flat payment for one service as the code defines it.

Do managed-care plans pay the same rate for D6722?

Not necessarily. In 2 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 3 states, plans negotiate and the published rate is a benchmark or out-of-network default. In 2 states, the service is paid outside the plans or through a state-directed payment. The rule for the remaining 5 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.