Delaware Medicaid Dental Coverage Guide
Delaware Medicaid Dental Coverage Guide: verify the Delaware authority path, document the current rule or credential, compare written provider terms, and continue through Find a Provider only after the evidence check.
Delaware Medicaid Dental Coverage Guide: verify the Delaware authority path, document the current rule or credential, compare written provider terms, and continue through Find a Provider only after the evidence check. Delaware Medicaid pays a dentist $90.28. Delaware Medicaid pays a dentist $53.07.
What this page recommends
Delaware Medicaid Dental Coverage Guide: verify the Delaware 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.
Delaware Medicaid dental reimbursement rates on this page are taken from DMAP Dental Fee Schedule, published by Delaware Division of Medicaid and Medical Assistance, and retrieved 2026-08-26. The schedule is effective 2026-04-01. 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. Delaware operates a limited adult dental benefit for adults 21 and over; children's dental care is required federally under EPSDT. Verified 2026-08-26.
Delaware Medicaid dental reimbursement: what the program pays a dentist, not what a patient pays
| Procedure (CDT code) | What Delaware Medicaid pays the dentist | Rate basis |
|---|---|---|
| Cleaning (prophylaxis), adult (CDT D1110) | Delaware Medicaid pays a dentist $90.28 | State reimbursement, effective 2026-04-01 |
| Periodic oral exam (CDT D0120) | Delaware Medicaid pays a dentist $53.07 | State reimbursement, effective 2026-04-01 |
| Crown, porcelain/ceramic (CDT D2740) | Delaware Medicaid pays a dentist $1,512.65 | State reimbursement, effective 2026-04-01 |
| Root canal, molar tooth (CDT D3330) | Delaware Medicaid pays a dentist $1,173.04 | State reimbursement, effective 2026-04-01 |
| Extraction, erupted tooth (simple) (CDT D7140) | Delaware Medicaid pays a dentist $228.42 | State reimbursement, effective 2026-04-01 |
| Comprehensive oral exam (CDT D0150) | Delaware Medicaid pays a dentist $90.89 | State reimbursement, effective 2026-04-01 |
| Cleaning (prophylaxis), child (CDT D1120) | Delaware Medicaid pays a dentist $66.49 | State reimbursement, effective 2026-04-01 |
| Fluoride varnish (paediatric preventive) (CDT D1206) | Delaware Medicaid pays a dentist $39.04 | State reimbursement, effective 2026-04-01 |
| Sealant, per tooth (paediatric preventive) (CDT D1351) | Delaware Medicaid pays a dentist $52.46 | State reimbursement, effective 2026-04-01 |
| Amalgam filling, one surface (CDT D2140) | Delaware Medicaid pays a dentist $201.35 | State reimbursement, effective 2026-04-01 |
| Composite filling, one surface, posterior (CDT D2391) | Delaware Medicaid pays a dentist $249.57 | State reimbursement, effective 2026-04-01 |
| Crown, porcelain fused to predominantly base metal (CDT D2751) | Delaware Medicaid pays a dentist $1,417.90 | State reimbursement, effective 2026-04-01 |
| Crown, full cast predominantly base metal (CDT D2791) | Delaware Medicaid pays a dentist $1,373.90 | State reimbursement, effective 2026-04-01 |
| Root canal, anterior tooth (CDT D3310) | Delaware Medicaid pays a dentist $866.19 | State reimbursement, effective 2026-04-01 |
| Root canal, premolar tooth (CDT D3320) | Delaware Medicaid pays a dentist $972.83 | State reimbursement, effective 2026-04-01 |
| Complete denture, upper (CDT D5110) | Delaware Medicaid pays a dentist $2,083.26 | State reimbursement, effective 2026-04-01 |
| Complete denture, lower (CDT D5120) | Delaware Medicaid pays a dentist $2,077.07 | State reimbursement, effective 2026-04-01 |
| Surgical extraction, erupted tooth (CDT D7210) | Delaware Medicaid pays a dentist $329.55 | State reimbursement, effective 2026-04-01 |
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
- DMAP Dental Fee Schedule — Official Delaware Medicaid dental fee schedule: amounts the state pays a dental provider per CDT procedure. Not consumer prices.; reviewed 2026-08-26
- Delaware Medicaid adult dental benefit scope — Delaware's own statement of what dental care adult Medicaid members receive; reviewed 2026-08-26
Delaware publishes its Medicaid dental reimbursement rates in DMAP Dental Fee Schedule. Those rates are what Delaware 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 Delaware reimbursement figure cannot answer what a filling or a crown would cost you. It does answer what Delaware Medicaid will pay a dentist who accepts it. The figures on this page were retrieved 2026-08-26.
Quick checklist
- Write the Delaware question in one sentence.
- Select Delaware 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
- A Delaware claim with no source date
- A provider who will not identify the governing authority
- A price, deadline, or eligibility statement presented as universal
Adult and child dental benefits are set differently in Delaware. 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. Delaware operates a limited adult dental benefit for adults aged 21 and over. In the state's own words: "Dental services are covered for adults age 21 and above. Additional services may be accessed through the emergency benefit once the $1,000 annual benefit limit is reached. Up to an additional $1,500 per calendar year per individual may be provided with prior authorization." Confirm your own category before booking, because Delaware eligibility groups can differ. Verified 2026-08-26.
Quick checklist
- Write the Delaware question in one sentence.
- Select Delaware 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
- A generic fifty-state chart replacing Delaware primary material
- No license or designation verification
- Pressure to act before written terms are supplied
For “What should I confirm before booking Medicaid dental care in Delaware?,” A current Delaware answer starts at Medicaid.gov’s Delaware profile and the current Delaware Medicaid dental program materials and then narrows to the exact facts, date, and service involved. Your written comparison should cover child EPSDT obligations, optional adult coverage, covered service categories, prior authorization, managed-care network rules, and current state contacts. The final action is a provider search informed by the source record, not an unsourced recommendation.
Quick checklist
- Name the exact Delaware decision and the date that could change it.
- Select Delaware 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
- A generic fifty-state chart replacing Delaware primary material
- No license or designation verification
- Pressure to act before written terms are supplied
For “How do prior authorization and managed-care rules affect Delaware dental access?,” The controlling verification path for Delaware runs through Medicaid.gov’s Delaware profile and the current Delaware 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 Delaware.
- Select Delaware in Medicaid.gov’s state profiles, then confirm adult and child dental benefits in the state program documents.
- Separate federal rules from Delaware-specific rules.
- Ask the provider to explain any conflict in writing.
Red flags
- A generic fifty-state chart replacing Delaware primary material
- No license or designation verification
- Pressure to act before written terms are supplied
For “When should I use Find a Provider for Medicaid dental care in Delaware?,” In Delaware, verify the rule or credential through Medicaid.gov’s Delaware profile and the current Delaware Medicaid dental program materials before comparing providers or acting. A provider-facing checklist should test child EPSDT obligations, optional adult coverage, covered service categories, prior authorization, managed-care network rules, and current state contacts. The provider CTA is the next step, not a substitute for verifying the governing source.
Quick checklist
- Identify the person, service, and jurisdiction involved in Delaware.
- Select Delaware in Medicaid.gov’s state profiles, then confirm adult and child dental benefits in the state program documents.
- Separate federal rules from Delaware-specific rules.
- Ask the provider to explain any conflict in writing.
Red flags
- A Delaware claim with no source date
- A provider who will not identify the governing authority
- A price, deadline, or eligibility statement presented as universal
Need help applying this guide?
- Connecticut Medicaid Dental Coverage Guide
- Florida Medicaid Dental Coverage Guide
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