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Medicaid Fee Schedules

School of Dentistry

Access Adult Medicaid Fee Schedule Here
Access Pediatric Medicaid Fee Schedule Here

Disclaimers for Dental Fee Schedule:

  • Please note that some of these codes may have restrictions, such as the requirement for prior authorizations.
  • To access up-to-date coverage and reimbursement information, visit the Coverage and Reimbursement Fee Schedule Download Tool. This information can be found using the Provider Type Specific Download and selecting provider type 028 for Dentist.
  • The 20 percent enhancement to standard Medicaid reimbursement rates applies to providers in rural counties outside of the Wasatch Front. Providers operating in Salt Lake, Weber, Davis, and Utah Counties must sign and submit the Dental Agreement Form to receive the 20 percent enhancement.