Medicaid dental coverage by state: adult benefit levels and what the program pays dentists
Choose a procedure: the calculator ranks the priced states by its typical fee, next to the Medicaid fee each program pays for the same codes.
Simple extraction: median of 26 states, full fee
$230
From $139 in Florida to $444 in Oregon (per tooth).
| Highest: Oregon | $444 |
| Median | $230 |
| Lowest: Florida | $139 |
States whose Medicaid schedule lists every code of the procedure. Estimates, not quotes.
| State | Full fee | In network | Medicaid fee, 2024 |
|---|---|---|---|
| Oregon | $444 | $304 | $100 |
| Maryland | $337 | $171 | $135 |
| Indiana | $314 | $195 | $137 |
| Minnesota | $304 | $190 | $89 |
| Colorado | $290 | $165 | $109 |
| Connecticut | $284 | $167 | $75 |
| South Carolina | $268 | $177 | $89 |
| Pennsylvania | $262 | $130 | $65 |
| Massachusetts | $258 | $140 | $77 |
| Ohio | $258 | $152 | $113 |
| Arizona | $244 | $120 | $88 |
| Virginia | $231 | $133 | $92 |
| Georgia | $231 | $136 | $81 |
| Illinois | $229 | $137 | $54 |
| Kentucky | $226 | $127 | $83 |
| New York | $219 | $108 | $51 |
| North Carolina | $208 | $134 | $66 |
| Louisiana | $206 | $132 | $107 |
| Michigan | $205 | $125 | $93 |
| Oklahoma | $185 | $124 | $74 |
| Missouri | $179 | $105 | $94 |
| Washington | $176 | $108 | $61 |
| Texas | $173 | $98 | $64 |
| Nevada | $157 | $83 | $47 |
| Alabama | $157 | $94 | $64 |
| Florida | $139 | $74 | $27 |
Compiled by Radif Partners · How prices are estimated · state Medicaid fee schedules, ADA ratios of 2024, BLS dental price index · not a quote
Medicaid must cover dental care for every enrolled child, but adult dental care is optional and each state decides what to offer, with no federal minimum, as the federal Medicaid agency states. The result is a patchwork. In the classification the ADA Health Policy Institute published in 2024 with CareQuest, 34 of the fifty states and the District of Columbia gave adults an enhanced benefit, 8 a limited one, 8 covered emergencies only and 1 offered none. How much Medicaid pays also varies: for adults it paid from 12 % of what dentists charged in New Hampshire to 78 % in Delaware, 30 % on average, and for children 39 % on average. Those ratios are the basis of every price on this site. Benefits change with state budgets, so a 2024 level may not be today's: the state Medicaid agency has the current rules and decides eligibility.
Children and adults are treated differently
For children, federal law sets the floor. Medicaid.gov states that Medicaid covers dental services for all child enrollees as part of a comprehensive set of benefits, and that separate CHIP programs must also include dental coverage. Checkups, cleanings, fillings and medically necessary treatment are therefore available to enrolled children in every state, whatever the adult rules.
For adults, the same page says that states have flexibility to decide what dental benefits to provide and that there are no minimum requirements. Some states cover adults almost as broadly as children; others pay only to relieve pain or treat infection; a few pay nothing. The level can change from one budget year to the next.
The four levels of adult coverage
The ADA Health Policy Institute classifies each state's adult benefit, using information from CareQuest and its own research, in its 2024 workbook. The levels, from broadest to narrowest:
- Enhanced: the broadest level, a wider set of covered services for adults. 34 jurisdictions in 2024.
- Limited: a narrower set of covered services. 8 states: Arkansas, Delaware, Indiana, Kansas, Kentucky, Louisiana, South Carolina, Wyoming.
- Emergency only: care for pain and infection, without routine care. 8 states: Arizona, Florida, Georgia, Mississippi, Missouri, Nevada, Texas, Utah.
- None: no adult dental benefit. One state: Alabama.
Within one state, some groups of adults can have dental coverage under rules of their own. The exact list of covered services at each level is set by each state, and the state Medicaid agency is the place to check what applies to a given person; this site does not assess eligibility.
All fifty states and the District of Columbia
The table gives each jurisdiction's adult benefit level and the two ratios between Medicaid fee-for-service pay and dentists' charges, for adults and for children, as published by the ADA for 2024. States in bold link to their price page on this site.
| State | Adult benefit, 2024 | Medicaid pay / dentist charges, adults | Medicaid pay / dentist charges, children |
|---|---|---|---|
| Alabama | None | n/a | 46.4 % |
| Alaska | Enhanced | 44.5 % | 51.9 % |
| Arizona | Emergency only | n/a | 40.8 % |
| Arkansas | Limited | 31.2 % | 36.1 % |
| California | Enhanced | 41.4 % | 36.9 % |
| Colorado | Enhanced | 42.8 % | 45.0 % |
| Connecticut | Enhanced | 29.9 % | 47.0 % |
| Delaware | Limited | 78.0 % | 80.1 % |
| District of Columbia | Enhanced | 39.3 % | 47.8 % |
| Florida | Emergency only | n/a | 22.2 % |
| Georgia | Emergency only | n/a | 39.8 % |
| Hawaii | Enhanced | 44.1 % | 49.7 % |
| Idaho | Enhanced | 33.9 % | 34.7 % |
| Illinois | Enhanced | 26.6 % | 23.9 % |
| Indiana | Limited | 49.6 % | 49.7 % |
| Iowa | Enhanced | 29.9 % | 31.1 % |
| Kansas | Limited | 38.4 % | 35.3 % |
| Kentucky | Limited | 41.4 % | 43.3 % |
| Louisiana | Limited | 56.5 % | 59.1 % |
| Maine | Enhanced | 49.4 % | 47.0 % |
| Maryland | Enhanced | 45.6 % | 47.2 % |
| Massachusetts | Enhanced | 33.9 % | 44.6 % |
| Michigan | Enhanced | 51.7 % | 52.0 % |
| Minnesota | Enhanced | 33.1 % | 32.3 % |
| Mississippi | Emergency only | n/a | 51.0 % |
| Missouri | Emergency only | n/a | 59.3 % |
| Montana | Enhanced | 52.3 % | 51.3 % |
| Nebraska | Enhanced | 35.8 % | 37.7 % |
| Nevada | Emergency only | n/a | 34.2 % |
| New Hampshire | Enhanced | 11.6 % | 42.0 % |
| New Jersey | Enhanced | 12.2 % | 50.0 % |
| New Mexico | Enhanced | 36.0 % | 34.7 % |
| New York | Enhanced | 26.1 % | 34.1 % |
| North Carolina | Enhanced | 36.3 % | 34.3 % |
| North Dakota | Enhanced | 53.7 % | 55.3 % |
| Ohio | Enhanced | 50.0 % | 53.3 % |
| Oklahoma | Enhanced | 45.2 % | 38.0 % |
| Oregon | Enhanced | 25.5 % | 26.9 % |
| Pennsylvania | Enhanced | 28.2 % | 30.9 % |
| Rhode Island | Enhanced | 38.3 % | 40.2 % |
| South Carolina | Limited | 37.6 % | 47.2 % |
| South Dakota | Enhanced | 63.4 % | 64.6 % |
| Tennessee | Enhanced | 39.6 % | 41.8 % |
| Texas | Emergency only | n/a | 42.1 % |
| Utah | Emergency only | n/a | 42.8 % |
| Vermont | Enhanced | 59.0 % | 57.6 % |
| Virginia | Enhanced | 45.5 % | 46.3 % |
| Washington | Enhanced | 39.4 % | 30.7 % |
| West Virginia | Enhanced | 49.0 % | 56.8 % |
| Wisconsin | Enhanced | 29.1 % | 30.7 % |
| Wyoming | Limited | 37.1 % | 52.0 % |
Why low pay matters to patients
A low ratio means that an office receives much less for a visit paid by Medicaid than for the same visit paid by a patient or a private plan. Whether an office takes Medicaid patients is its own decision, and the state agency or the health plan can list the offices that do. Children's ratios are generally higher than adults', 39 % against 30 % nationally, and range from 22 % in Florida to 80 % in Delaware.
Many states pay dentists through managed care plans rather than directly, and those plans' rates are not public. The ADA ratios, like this site's estimates, use the public fee-for-service schedules, which is a limit both share.
Typical fee and Medicaid fee, state by state
Simple extraction: median of 26 states, full fee
$230
| Highest: Oregon | $444 |
| Median | $230 |
| Lowest: Florida | $139 |
Reading a state's ratio
A ratio compares a weighted basket of common codes, the same basket in every state: exams, cleanings, X-rays, fillings and extractions. It does not say that every code is paid at that share. A state can pay a filling close to private fees and a crown far below them, or the reverse. That is why the estimates on this site are made code by code, from the state's own fee for each code, and why a state's estimate for a procedure can sit far from its neighbors when one fee is set on a different basis.
A ratio also moves when either side moves. A state that raises its fees after July 2024 has a higher ratio today than the table shows, until the ADA publishes new figures, and a state where dentists' fees rise faster than Medicaid's has a lower one. The table is the latest public measure, not a forecast.
From Medicaid fees to prices
Because each ratio relates Medicaid pay to dentists' charges in the same state, dividing a state's Medicaid fee for a code by its ratio estimates what dentists there charge for it. That is how every price on this site is built, for the 27 states whose fee schedules have been read and dated so far. The method page gives the steps, the state comparison the results, and the page on paying without insurance the options for adults whose state covers little. Medicare, the federal program for people 65 and over, is separate and generally does not cover routine dental care, as Medicare.gov explains.