Skip to content
Billing code D7910 · Dental

D7910 Medicaid reimbursement rate by state (2026)

Dental services. Medicaid pays a median of $119.60 for D7910 across 35 states, from $27.97 in Nevada to $338.50 in Delaware.

Data as of Oct 5, 202635 statesEvery rate links to its official source

States publishing
35
National median
$119.60units vary by state
Lowest
$27.97Nevada
Highest
$338.50Delaware
Answer

What does Medicaid pay for D7910?

35 state Medicaid programs publish a fee-for-service rate for D7910. The national median is $119.60 (units differ between states). Delaware pays the most, $338.50, and Nevada the least, $27.97, a 12.1x spread.

State ranking

D7910 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 35 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Delaware Source · since 2026-04-01$338.50——Not classified—
2Colorado Source · since 2026-07-01$238.53——Paid by the state, outside plans—
3Georgia Source · since 2026-10-01$223.84——Plans negotiate; applies out of network—
17Oklahoma Source · since 2024-01-01$128.05——Plans must pay at least this—
18Hawaii Source · since 2024-03-04$119.60——Paid by the state, outside plans—
19Virginia Source · since 2010-10-01$118.72——Paid by the state, outside plans—
34Rhode Island Source · since 2022-07-01$31.00——Paid by the state, outside plans—
35Nevada Source · since 2024-01-01$27.97——Plans must pay at least this—
See all 35 states for D7910 — start free

27 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.

  • Source for every rate
  • Full rate history
  • CSV and API export

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 D7910 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 D7910, 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. 19 of the 35 states list more than one rate for D7910, 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 35 states, 1 publish D7910 per unit and 1 per percent of sma, and 33 schedules print no unit at all (a flat amount per service).
  • Per hour. D7910 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 D7910, 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 D7910 rates differ between states

Published rates for D7910 run from $27.97 in Nevada to $338.50 in Delaware, a 12.1x gap in the same unit. Half the states pay more than the median of $119.60 and half pay less. The usual reasons for a spread like this in dental rates:

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

Timing matters too. 10 states set the current rate for D7910 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 D7910

No managed-care plan publishes what it pays for D7910. 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 6 states, plans negotiate and the published rate is a benchmark or out-of-network default. In 8 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 (8 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 (6 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 D7910

D7910 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 D7910?

It depends on the state. Of the 35 states with a published fee-for-service rate, the median is $119.60. Delaware pays the most ($338.50) and Nevada the least ($27.97).

Which state pays the highest Medicaid rate for D7910?

Delaware, at $338.50, effective 2026-04-01.

Which state pays the lowest Medicaid rate for D7910?

Nevada, at $27.97, effective 2024-01-01.

What unit is D7910 billed in?

Of the 35 states, 1 publish D7910 per unit and 1 per percent of sma, and 33 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for D7910?

Not necessarily. In 10 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 6 states, plans negotiate and the published rate is a benchmark or out-of-network default. In 8 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.