Florida Medicaid Dental General Fee Schedule 2026

The 2026 Florida Medicaid dental fee schedule has established new reimbursement standards or benchmark values for all CDT-coded services (preventive, diagnostic, and restorative). This fee schedule will help you understand how providers are reimbursed for those services. The 2026 Florida Medicaid dental reimbursement rates are based on the AHCA fee schedule. It shows how much providers are paid for each dental service.

The fee schedule distinguishes between pediatric (ages 0-20) and adult coverage within Florida Medicaid dental coverage.

Examples of how reimbursement rises with complexity include:

• D0120 periodic oral evaluation, which pays approximately $22.39.
• Prophylaxis (D1110) pays approximately $42.70 for children and $26.75 for adults.
• Porcelain-fused crowns, such as D2740, are reimbursed at around $340.37.

Pediatric services make up the majority of covered services. Adult services are limited and typically paid lower rates than pediatric services. Further, some higher-cost procedures may require prior authorization using one of Florida Medicaid’s prior-authorization dental codes to enforce medical necessity and cost control.

Florida Medicaid CDT Dental Codes and Payment Rates 2026

How Is The Florida Medicaid Dental Fee Schedule 2026 Organized?

Florida Medicaid dental billing rates, by code, provide a structured reimbursement system based on procedure complexity, age eligibility, and authorization requirements.

Florida Medicaid focuses on services for children; most CDT codes are reimbursable through age 20 (through a patient’s 20th birthday), whereas adults have a shorter list of covered services and often receive lower payment amounts.

Adult services are generally reimbursed for specific categories of diagnostic, extraction, anesthesia, and prosthodontic services. However, even when adult rates do exist, they are always less than pediatric reimbursement levels.

There are clearly defined tiers in the Florida Medicaid dentist reimbursement guide:

Minimum Reimbursements:

• These include minor adjunct services such as D2951 ($2.98), which represent minimal reimbursement amounts.
• Preventive/diagnostic care often ranges from roughly $10 to about $43.
• A periodic oral evaluation (D0120) pays around $22.39.
• Prophylaxis (D1110) pays about $42.70 for children and about $26.75 for adults.

Restorative procedures ($40-$110):

• Fillings and composite restorations such as D2140 ($46.28) and D2335 ($107.48)

Major treatments ($150-$350+):

• Crowns and endodontics, including D2740 ($340.37) and D3330 ($350.82)

High cost procedures ($400-$567+):

• Dentures (D5110: $462.78 pediatric/ $311.37 adult)
• Orthodontic services (D8070/D8090: $567.28)

Prior Authorization (PA) applies to the more advanced procedures listed above, including periodontal surgery, prosthodontics, orthodontics, and implant procedures. Prior authorization is a vital part of the revenue cycle, verifying that the patient requires the treatment per Florida Medicaid prior-authorization dental codes.

Therefore, for dentists who want to know how much Florida Medicaid will pay for each type of dental procedure, this document will serve as a guide for 2026. Moreover, it will serve as a source of information for developing an effective plan to code accurately, comply with Florida Medicaid guidelines, and generate revenue.

Preventive Dental Care CDT Codes & Fee Schedule

Code	0–20	21+	Max Age	PA
D0120	$22.39	–	$20	–
D0145	$23.88	–	$3	–
D1110	$42.70	$26.75	$20	–
D1120	$33.21	–	$20	–
D1206	$26.09	–	$20	–
D1208	$26.09	–	$20	–
D1330	$14.24	$8.92	$20	–
D1351	$30.84	–	$20	–
D1354	$10.28	–	$20	–
D1355	$10.28	–	$20	–

Preventive services are paid at fixed amounts set by AHCA; rates for cleanings and fluoride treatments in 2026 generally range from about $10 to $43. Most of these procedures are paid between $10 and $43, which makes them low-risk and easy to predict.

Preventive services are among the most stable parts of the Florida Medicaid dental reimbursement rates in 2026. Based on the Florida Medicaid dental CDT codes for 2026, these fees primarily apply to those younger than 21. This also illustrates the broader trend that pediatric and adult preventive services are covered by Florida Medicaid, with much greater amounts provided for children than for adults.

In what ranges do most of the preventive codes fall?

• Between $10-$14: Sealants, basic fluoride treatment, etc.
• Between $22-$26: Routine examinations, including D-0120; fluoride treatments
• Between $30 and $33: A few, but slightly more involved, preventive services.
• Around $43: Adult cleanings (D-1110), commonly described as the Florida Medicaid Prophylaxis Rate.

Dental Diagnostic Procedure (Exam and X-ray) CDT Codes & Fee Schedule

Code	0–20	21+	Max Age	PA
D0140	$11.94	$8.04	$999	–
D0150	$23.88	$16.07	$999	–
D0190	$10.45	–	$20	–
D0191	$10.45	–	$20	–
D0210	$47.77	$32.14	$999	–
D0220	$5.98	$4.02	$999	–
D0230	$4.48	$3.01	$999	–
D0240	$11.94	$8.04	$999	–
D0250	$35.83	–	$20	–
D0251	$35.27	–	$20	–
D0270	$8.96	–	$20	–
D0272	$13.44	–	$20	–
D0274	$16.42	–	$20	–
D0330	$44.79	$30.13	$999	–
D0340	$47.77	–	$20	–
D0350	$10.45	–	$20	–
D0470	$32.84	–	$20	–

Florida Medicaid covers a wide range of dental diagnostic procedures as defined in the Florida AHCA dental fee schedule for 2026. The reimbursement for diagnostic procedures ranges from $3 to $48. The diagnostic procedures covered by the fee schedule include exams, bitewing radiographs, and panoramic imaging.

These diagnostic procedures are generally reimbursed at the low rate under Florida Medicaid. The average payment amounts are:

• Basic Radiographic Services – $3 to $9
• Routine Diagnostic Procedures – $10 to $13
• Detailed Imaging – $16 to $35
• Full-Mouth Panoramic Radiograph- $44 to $48

Filling and Crown Procedure CDT Codes & Fee Schedule

Code	0–20	21+	Max Age	PA
D2140	$46.28	–	$20	–
D2150	$61.21	–	$20	–
D2160	$76.13	–	$20	–
D2161	$91.06	–	$20	–
D2330	$50.75	–	$20	–
D2331	$58.23	–	$20	–
D2332	$65.69	–	$20	–
D2335	$107.48	–	$20	–
D2390	$107.48	–	$20	–
D2391	$46.28	–	$20	–
D2392	$61.21	–	$20	–
D2393	$76.13	–	$20	–
D2394	$91.06	–	$20	–
D2710	$114.95	–	$20	–
D2721	$126.90	–	$20	–
D2740	$340.37	–	$20	–
D2751	$340.37	–	$20	–

A complete reversal of payment patterns occurs with restorative procedures. The reimbursement amounts for restorative procedures can vary from $46 to approximately $340. This is also where significant increases in Florida Medicaid Dental Reimbursement Rates for crowns occur.

Here are the reimbursement rate ranges:

• Fillings: $46–$58
• Moderate Restoratives: $60–$76
• Larger Restoratives and Crown Prep: $107–$126
• Crown Full (Example D2740): ~$340

Florida Medicaid reimburses filling at $46–$58. Moreover, in 2026, Porcelain‑fused crowns (e.g., D2740) cost around $340. The reason why their reimbursement rate is more than fillings is that they are considered major restorative procedures.

Root Canal Procedure CDT Codes & Fee Schedule

Code	0–20	21+	Max Age	PA
D3110	$19.41	–	$20	–
D3120	$16.42	–	$20	–
D3220	$74.65	–	$20	–
D3221	$44.79	–	$20	–
D3222	$64.87	–	$20	–
D3230	$111.96	–	$20	–
D3240	$126.90	–	$20	–
D3310	$220.94	–	$20	–
D3320	$283.64	–	$20	–
D3330	$350.82	–	$20	–
D3331	$74.65	–	$20	–
D3333	$46.28	–	$20	–
D3351	$125.40	–	$20	–
D3352	$83.60	–	$20	–
D3353	$167.20	–	$20	–
D3410	$111.96	–	$20	–
D3430	$37.32	–	$20	–

The cost of an Endodontic procedure (a Root Canal) will fall into one of several ranges, ranging from $16 to $350. It is likely the most varied category in the 2026 Florida Medicaid Dental reimbursement rate.

How does the cost affect what you pay?

• The lower range ($16-$37): Basic root canal.
• The middle range ($44-$74): Average root canals.
• The upper range  ($64-$126): More complicated root canals that have multiple roots.
• The highest range ($280-$350): Root Canals on molars.

The main reason the fees vary is the complexity of the procedure. For instance, simple root canals require less work. Hence, they cost far less than multi‑root or molar procedures, which are time-consuming and complex.

Periodontal Procedures CDT Codes & Fee Schedule

Code	0–20	21+	Max Age	PA
D4210	$156.75	–	$20	–
D4211	$67.17	–	$20	–
D4240	$322.08	–	$20	Y
D4241	$205.06	–	$20	Y
D4260	$170.19	–	$20	–
D4261	$71.65	–	$20	–
D4341	$29.86	–	$20	–
D4342	$14.93	–	$20	–
D4346	$119.42	–	$20	–
D4355	$77.63	–	$20	–

The costs for periodontal (or gum disease) services under Florida Medicaid’s 2026 fee schedule vary widely. Higher‑cost periodontal surgeries (e.g., gingival flap procedures and osseous surgeries) usually require prior authorization, while routine scaling and root planing often do not. Providers should check the official AHCA fee schedule or managed‑care plan policies for specific prior‑authorization requirements.

Florida Medicaid may cover non-surgical treatments with little or no scrutiny. On the other hand, almost all periodontal surgical treatments qualify under Florida Medicaid’s prior authorization dental codes.

How does reimbursement work?

• Routine scalings ($15-$30): Usually do not require prior authorization and include routine cleanings for maintaining gum health.
• Moderate scaling ($67-$77): May require supporting documentation; however, on most occasions, this process will occur without a pre-authorization.
• Surgery (e.g., $156-$170): Almost all periodontal surgeries require prior authorization. Documentation of clinical necessity must be provided, including evidence of disease activity.
• Advanced gum surgery ($205-$322): Most advanced gum surgeries will require prior authorization. Case documentation and X-rays, etc. Florida Medicaid will review this to determine whether payment should be made or not.

The more complex the service, the more documentation is required along with prior authorization. As stated above, prior authorization is an important part of the Florida Medicaid dental billing guidelines in 2026 and demonstrates how reimbursements are managed through the Florida Medicaid system.

Prosthodontics CDT Codes & Fee Schedule

Code	0–20	21+	Max Age	PA
D5110	$462.78	$311.37	$999	Y
D5120	$462.78	$311.37	$999	Y
D5211	$246.32	$165.73	$999	Y
D5212	$246.32	$165.73	$999	Y
D5213	$470.24	$316.39	$999	Y
D5214	$470.24	$316.39	$999	Y
D5410	$20.90	$14.06	$999	–
D5411	$20.90	$14.06	$999	–
D5421	$20.90	$14.06	$999	–
D5422	$20.90	$14.06	$999	–
D5511	$65.69	$44.19	$999	–
D5512	$65.69	$44.19	$999	–
D5520	$58.23	$39.17	$999	–
D5611	$65.69	$44.19	$999	–
D5612	$65.69	$44.19	$999	–
D5621	$70.17	$47.21	$999	–
D5622	$70.17	$47.21	$999	–
D5630	$83.60	$56.25	$999	–
D5640	$58.23	$39.17	$999	–
D5650	$62.70	$42.19	$999	–
D5660	$77.63	$52.23	$999	–
D5730	$94.05	$63.28	$999	–
D5731	$94.05	$63.28	$999	–
D5740	$94.05	$63.28	$999	–
D5741	$94.05	$63.28	$999	–
D5750	$168.69	$113.50	$999	–
D5751	$168.69	$113.50	$999	–
D5760	$168.69	$113.50	$999	–
D5761	$168.69	$113.50	$999	–
D5820	$164.21	–	$20	Y
D5821	$164.21	–	$20	Y
D6096	$59.71	$40.18	$999	Y
D6985	$246.32	–	$20	Y

Medicaid covers prosthodontic procedures as part of its dental fee schedule. It includes dentures, repairs, and other types of restorative prosthetics. The fees paid by Medicaid can vary greatly depending on what type of service was rendered and whether or not there were certain restrictions based upon the patient’s age group (adults 21+ vs children 0-20).

Full dentures and partials (codes D5110–D5214) usually require prior authorization due to their high cost, whereas minor adjustments and repairs generally do not.

Here’s how the current reimbursement rates for prosthodontic services are generally structured in terms of their CDT codes:

• $14-$21 (D5410-D5422): Minor adjustments and small repair jobs. No prior authorization is usually required.
• $39-$83 (D5511-D5660): Repair work, reline work, and general maintenance. These can typically be billed through the normal process.
• $63-$168 (D5730-D5761): More advanced prosthetic work that requires additional time. This also usually does not require prior authorization.
• $165-$470 (D5110-D5214): Full dentures and partial dentures. Prior authorization is almost always required due to the high expense involved.

You can easily submit bills for simple prosthetic services, but the billing process for full dentures is much more complicated.

Oral Surgical Procedures, Extractions CDT Codes & Fee Schedule

Code	0–20	21+	Max Age	PA
D7111	$40.31	–	$20	–
D7140	$40.31	$27.12	$999	–
D7210	$59.71	$40.18	$999	–
D7220	$92.56	$62.27	$999	–
D7230	$114.95	$77.34	$999	–
D7240	$117.94	$79.35	$999	–
D7241	$122.42	$82.36	$999	–
D7250	$80.61	$54.24	$999	–
D7260	$250.80	$168.74	$999	–
D7261	$179.15	$120.53	$999	–
D7270	$40.31	–	$20	–
D7280	$203.03	–	$20	–
D7283	$176.15	–	$20	–
D7296	$176.15	–	$20	–
D7297	$176.15	–	$20	–
D7310	$67.17	$45.20	$999	–
D7320	$83.60	$56.25	$999	–
D7472	$261.83	$176.16	$999	–
D7473	$261.83	$176.16	$999	–
D7510	$70.17	$47.21	$999	–
D7520	$100.02	$67.30	$999	–

Oral surgical procedures under the Florida Medicaid Dental Fee Schedule 2026 are reimbursed at fixed rates based on CDT codes. Rates typically range from about $27 to $261, increasing with procedural complexity.

How does the fee schedule work?

• D7111, D7140: Simple extractions ($27-$40). This is the lowest-paying area of the fee schedule.
• Surgical extractions (D7210-D7250): $40-$80. These pay slightly more because they are more complicated.
• Impact removals of affected teeth (D7220-D7241): $92-$122. More difficult than an extraction but less difficult than advanced oral surgery. Therefore, these have mid-range payments.
• Advanced oral surgery (D7260-D7472): $168-$261.These are the highest-paying codes for all oral surgical areas.
• Age-limited codes (D7280, D7296): These codes apply mostly to children under 20 years old and reflect that children receive dental insurance differently than adult recipients.

Orthodontic Procedures CDT Codes & Fee Schedule

Code	0–20	21+	Max Age	PA
D8070	$567.28	–	$20	Y
D8080	$567.28	–	$20	Y
D8090	$567.28	–	$20	Y
D8210	$161.23	–	$20	Y
D8220	$500.10	–	$20	Y
D8660	$97.04	–	$20	–
D8670	$77.63	–	$20	Y
D8680	$159.57	–	$20	Y
D8703	$94.05	–	$20	Y
D8704	$94.05	–	$20	Y

Orthodontic services are typically limited to children who meet strict medical‑necessity criteria. Adults rarely qualify for orthodontic coverage, and all comprehensive orthodontic treatments require prior authorization.

Orthodontic care has some of the most restrictive elements within the 2026 AHCA dental fee schedule for Florida. Orthodontic payments range from $77 to $567.

The majority of individuals eligible to receive orthodontic care via Florida Medicaid will be those who meet the medical necessity criteria for orthodontic care (i.e., pediatric patients).

These are payment ranges used for orthodontic services:

• $77-$97 (D8660, D8670) – minor adjustments or basic orthodontic services. These represent the lowest range of the orthodontic payment spectrum.
• $94-$161 (D8703, D8210) – retainer appliances and other devices that typically require pre-approval for payment.
• $500-$567 (D8070-D8090, D8220) – full orthodontic treatment. The highest possible range for orthodontic payments will always require pre-authorization.

Dental Anesthesia Support Services CDT Codes & Fee Schedule

Code	0–20	21+	Max Age	PA
D9110	$19.41	–	$20	–
D9222	$62.11	$41.79	$999	–
D9223	$62.11	$41.79	$999	–
D9230	$41.80	$28.12	$999	–
D9239	$62.11	$41.79	$999	–
D9243	$62.11	$41.79	$999	–
D9244	$50.76	$34.15	$999	–
D9245	$59.71	$40.18	$999	–
D9246	$62.11	$41.79	$999	–
D9247	$62.11	$41.79	$999	–
D9310	$26.87	–	$20	–
D9420	$83.60	$56.25	$999	–
D9920	$35.83	–	$20	–
D9995	–	–	–	–
D9996	–	–	–	–

Supporting anesthesia and adjunctive services in the Florida Medicaid dental fee schedule 2026 are relatively simple, less expensive support services than many of the others. Supporting Anesthesia and adjunctive services, considered one of the least complicated aspects of the system, generates a wide range of revenues from $19 to $83.

Here are the payment ranges:

• $19-$35 (D9110, D9920) – basic Support Services. The lowest payment level.
• $41-$62 (D9222-D9247) – Sedation and Anesthesia. A moderate to fairly stable payment structure.
• $56-$83 (D9420) – higher levels of support service. Slightly more revenue than Sedation and Anesthesia.
• D9995, D9996 (variable/non-standard) – there is no guarantee that these codes will be consistently reimbursed under the Florida Medicaid dental fee schedule 2026.