Colorado Medicaid Dental Coverage Guide
Colorado Medicaid Dental Coverage Guide: verify the Colorado authority path, document the current rule or credential, compare written provider terms, and continue through Find a Provider only after the evidence check.
Colorado Medicaid Dental Coverage Guide: verify the Colorado authority path, document the current rule or credential, compare written provider terms, and continue through Find a Provider only after the evidence check. Colorado Medicaid pays a dentist $80.74. Colorado Medicaid pays a dentist $31.76.
What this page recommends
Colorado Medicaid Dental Coverage Guide: verify the Colorado authority path, document the current rule or credential, compare written provider terms, and continue through Find a Provider only after the evidence check.
- Next step: Find a Provider
What should I verify before acting?
Verify the local workflow, provider fit, pricing details, and timing directly through the canonical guide or a qualified professional before making a decision.
Related decision paths people also use
These are nearby ways people describe the same decision before they move into local comparison, pricing, or urgent next-step mode.
Colorado Medicaid dental reimbursement rates on this page are taken from Health First Colorado Medicaid Dental FFS Fee Schedule, published by Colorado Department of Health Care Policy and Financing, and retrieved 2026-08-26. The schedule is effective 2026-07-01. Every amount shown is what the state pays a dental provider for the procedure. It is not a price a patient pays, and self-pay and insured prices are typically far higher. Colorado operates a limited adult dental benefit for adults 21 and over; children's dental care is required federally under EPSDT. Verified 2026-08-26.
Colorado Medicaid dental reimbursement: what the program pays a dentist, not what a patient pays
| Procedure (CDT code) | What Colorado Medicaid pays the dentist | Rate basis |
|---|---|---|
| Cleaning (prophylaxis), adult (CDT D1110) | Colorado Medicaid pays a dentist $80.74 | State reimbursement, effective 2026-07-01 |
| Periodic oral exam (CDT D0120) | Colorado Medicaid pays a dentist $31.76 | State reimbursement, effective 2026-07-01 |
| Crown, porcelain/ceramic (CDT D2740) | Colorado Medicaid pays a dentist $703.19 | State reimbursement, effective 2026-07-01 |
| Root canal, molar tooth (CDT D3330) | Colorado Medicaid pays a dentist $918.62 | State reimbursement, effective 2026-07-01 |
| Extraction, erupted tooth (simple) (CDT D7140) | Colorado Medicaid pays a dentist $106.89 | State reimbursement, effective 2026-07-01 |
| Comprehensive oral exam (CDT D0150) | Colorado Medicaid pays a dentist $50.54 | State reimbursement, effective 2026-07-01 |
| Cleaning (prophylaxis), child (CDT D1120) | Colorado Medicaid pays a dentist $60.49 | State reimbursement, effective 2026-07-01 |
| Fluoride varnish (paediatric preventive) (CDT D1206) | Colorado Medicaid pays a dentist $34.75 | State reimbursement, effective 2026-07-01 |
| Sealant, per tooth (paediatric preventive) (CDT D1351) | Colorado Medicaid pays a dentist $47.29 | State reimbursement, effective 2026-07-01 |
| Amalgam filling, one surface (CDT D2140) | Colorado Medicaid pays a dentist $107.82 | State reimbursement, effective 2026-07-01 |
| Composite filling, one surface, posterior (CDT D2391) | Colorado Medicaid pays a dentist $107.82 | State reimbursement, effective 2026-07-01 |
| Crown, porcelain fused to high noble metal (CDT D2750) | Colorado Medicaid pays a dentist $696.49 | State reimbursement, effective 2026-07-01 |
| Crown, porcelain fused to predominantly base metal (CDT D2751) | Colorado Medicaid pays a dentist $635.18 | State reimbursement, effective 2026-07-01 |
| Crown, full cast predominantly base metal (CDT D2791) | Colorado Medicaid pays a dentist $482.42 | State reimbursement, effective 2026-07-01 |
| Root canal, anterior tooth (CDT D3310) | Colorado Medicaid pays a dentist $662.28 | State reimbursement, effective 2026-07-01 |
| Root canal, premolar tooth (CDT D3320) | Colorado Medicaid pays a dentist $759.95 | State reimbursement, effective 2026-07-01 |
| Complete denture, upper (CDT D5110) | Colorado Medicaid pays a dentist $834.38 | State reimbursement, effective 2026-07-01 |
| Complete denture, lower (CDT D5120) | Colorado Medicaid pays a dentist $835.88 | State reimbursement, effective 2026-07-01 |
| Surgical extraction, erupted tooth (CDT D7210) | Colorado Medicaid pays a dentist $171.05 | State reimbursement, effective 2026-07-01 |
Ready to compare providers?
Use the source-backed framework above, then continue to the matching provider destination.
Verify the rule before acting
- State Medicaid and CHIP Profiles — State-specific Medicaid and CHIP program profile; reviewed 2026-08-26
- Dental Care — Federal dental benefit requirements and state-option context; reviewed 2026-08-26
- Dental Licensure by State — State dental board and licensure pathway discovery; reviewed 2026-08-26
- Health First Colorado Medicaid Dental FFS Fee Schedule — Official Colorado Medicaid dental fee schedule: amounts the state pays a dental provider per CDT procedure. Not consumer prices.; reviewed 2026-08-26
- Colorado Medicaid adult dental benefit scope — Colorado's own statement of what dental care adult Medicaid members receive; reviewed 2026-08-26
Colorado publishes its Medicaid dental reimbursement rates in Health First Colorado Medicaid Dental FFS Fee Schedule. Those rates are what Colorado Medicaid pays a dental provider for each procedure, and they are not prices a patient pays. A self-pay or insured price for the same procedure is normally much higher, so a Colorado reimbursement figure cannot answer what a filling or a crown would cost you. It does answer what Colorado Medicaid will pay a dentist who accepts it. The figures on this page were retrieved 2026-08-26.
Quick checklist
- Identify the person, service, and jurisdiction involved in Colorado.
- Select Colorado in Medicaid.gov’s state profiles, then confirm adult and child dental benefits in the state program documents.
- Separate federal rules from Colorado-specific rules.
- Ask the provider to explain any conflict in writing.
Red flags
- An authority link that does not identify Colorado or the topic
- A summary that hides exceptions
- A provider answer that changes when you ask for documentation
Adult and child dental benefits are set differently in Colorado. Children's dental coverage is federally required under EPSDT, so every state must cover medically necessary dental care for eligible children. Adult dental coverage is a state option, which is why it varies so sharply. Colorado operates a limited adult dental benefit for adults aged 21 and over. In the state's own words: "The adult dental benefit is available to eligible adult Health First Colorado members (21 and over). Effective July 1, 2026 adult members have a $3,000 yearly benefit limit. This means Health First Colorado will pay for up to $3,000 of covered services a year (July 1 - June 30). Emergency services and dentures do not count towards the yearly limit." Confirm your own category before booking, because Colorado eligibility groups can differ. Verified 2026-08-26.
Quick checklist
- Name the exact Colorado decision and the date that could change it.
- Select Colorado in Medicaid.gov’s state profiles, then confirm adult and child dental benefits in the state program documents.
- Save the source URL, page title, and review date in your notes.
- Compare provider scope and written terms before using Find a Provider.
Red flags
- An authority link that does not identify Colorado or the topic
- A summary that hides exceptions
- A provider answer that changes when you ask for documentation
For “What should I confirm before booking Medicaid dental care in Colorado?,” Before relying on a Colorado summary, confirm the issue through Medicaid.gov’s Colorado profile and the current Colorado Medicaid dental program materials. Record the source date and verify child EPSDT obligations, optional adult coverage, covered service categories, prior authorization, managed-care network rules, and current state contacts. After the source check, Find a Provider routes you to the relevant local directory or service path.
Quick checklist
- Write the Colorado question in one sentence.
- Select Colorado in Medicaid.gov’s state profiles, then confirm adult and child dental benefits in the state program documents.
- Check the exception, eligibility category, or license status that applies.
- Route to the canonical provider destination with the verified facts in hand.
Red flags
- An authority link that does not identify Colorado or the topic
- A summary that hides exceptions
- A provider answer that changes when you ask for documentation
For “How do prior authorization and managed-care rules affect Colorado dental access?,” The controlling verification path for Colorado runs through Medicaid.gov’s Colorado profile and the current Colorado Medicaid dental program materials; screenshots and blog charts are secondary. Use the source to separate general guidance from child EPSDT obligations, optional adult coverage, covered service categories, prior authorization, managed-care network rules, and current state contacts. Use Find a Provider only after the authority check so the next conversation starts with the right questions.
Quick checklist
- Identify the person, service, and jurisdiction involved in Colorado.
- Select Colorado in Medicaid.gov’s state profiles, then confirm adult and child dental benefits in the state program documents.
- Separate federal rules from Colorado-specific rules.
- Ask the provider to explain any conflict in writing.
Red flags
- An authority link that does not identify Colorado or the topic
- A summary that hides exceptions
- A provider answer that changes when you ask for documentation
For “When should I use Find a Provider for Medicaid dental care in Colorado?,” The defensible starting point in Colorado is Medicaid.gov’s Colorado profile and the current Colorado Medicaid dental program materials, not an undated national summary. Then confirm child EPSDT obligations, optional adult coverage, covered service categories, prior authorization, managed-care network rules, and current state contacts. Do not rely on the summary alone; verify first, then use Find a Provider.
Quick checklist
- Record the event date and the decision deadline for the Colorado issue.
- Select Colorado in Medicaid.gov’s state profiles, then confirm adult and child dental benefits in the state program documents.
- Capture the operative rule, not merely a search-result snippet.
- Use Find a Provider if interpretation or application remains uncertain.
Red flags
- A stale screenshot used as the only evidence
- No distinction between federal and Colorado requirements
- A recommendation based only on advertising position
Need help applying this guide?
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