Florida Medicaid Dental Coverage Guide
Florida Medicaid Dental Coverage Guide: verify the Florida authority path, document the current rule or credential, compare written provider terms, and continue through Find a Provider only after the evidence check.
Florida Medicaid Dental Coverage Guide: verify the Florida authority path, document the current rule or credential, compare written provider terms, and continue through Find a Provider only after the evidence check. Florida Medicaid pays a dentist $42.70 for a patient under 21.
What this page recommends
Florida Medicaid Dental Coverage Guide: verify the Florida 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.
Florida Medicaid dental reimbursement rates on this page are taken from Florida Medicaid Dental General Services Fee Schedule, published by Florida Agency for Health Care Administration, 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. Florida operates an emergency-only adult dental benefit for adults 21 and over; children's dental care is required federally under EPSDT. Verified 2026-08-26.
Florida Medicaid dental reimbursement: what the program pays a dentist, not what a patient pays
| Procedure (CDT code) | Paid to the dentist for a patient under 21 | Paid to the dentist for a patient 21 and over |
|---|---|---|
| Cleaning (prophylaxis), adult (CDT D1110) | Florida Medicaid pays a dentist $42.70 for a patient under 21 | No rate listed for this age group |
| Periodic oral exam (CDT D0120) | Florida Medicaid pays a dentist $22.39 for a patient under 21 | No rate listed for this age group |
| Crown, porcelain/ceramic (CDT D2740) | Florida Medicaid pays a dentist $340.37 for a patient under 21 | No rate listed for this age group |
| Root canal, molar tooth (CDT D3330) | Florida Medicaid pays a dentist $350.82 for a patient under 21 | No rate listed for this age group |
| Extraction, erupted tooth (simple) (CDT D7140) | Florida Medicaid pays a dentist $40.31 for a patient under 21 | $27.12 paid to the dentist for a patient 21 and over |
| Comprehensive oral exam (CDT D0150) | Florida Medicaid pays a dentist $23.88 for a patient under 21 | $16.07 paid to the dentist for a patient 21 and over |
| Cleaning (prophylaxis), child (CDT D1120) | Florida Medicaid pays a dentist $33.21 for a patient under 21 | No rate listed for this age group |
| Fluoride varnish (paediatric preventive) (CDT D1206) | Florida Medicaid pays a dentist $26.09 for a patient under 21 | No rate listed for this age group |
| Sealant, per tooth (paediatric preventive) (CDT D1351) | Florida Medicaid pays a dentist $30.84 for a patient under 21 | No rate listed for this age group |
| Composite filling, one surface, posterior (CDT D2391) | Florida Medicaid pays a dentist $46.28 for a patient under 21 | No rate listed for this age group |
| Crown, porcelain fused to predominantly base metal (CDT D2751) | Florida Medicaid pays a dentist $340.37 for a patient under 21 | No rate listed for this age group |
| Root canal, anterior tooth (CDT D3310) | Florida Medicaid pays a dentist $220.94 for a patient under 21 | No rate listed for this age group |
| Root canal, premolar tooth (CDT D3320) | Florida Medicaid pays a dentist $283.64 for a patient under 21 | No rate listed for this age group |
| Complete denture, upper (CDT D5110) | Florida Medicaid pays a dentist $462.78 for a patient under 21 | $311.37 paid to the dentist for a patient 21 and over |
| Complete denture, lower (CDT D5120) | Florida Medicaid pays a dentist $462.78 for a patient under 21 | $311.37 paid to the dentist for a patient 21 and over |
| Surgical extraction, erupted tooth (CDT D7210) | Florida Medicaid pays a dentist $59.71 for a patient under 21 | $40.18 paid to the dentist for a patient 21 and over |
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
- Florida Medicaid Dental General Services Fee Schedule — Official Florida Medicaid dental fee schedule: amounts the state pays a dental provider per CDT procedure. Not consumer prices.; reviewed 2026-08-26
- Florida Medicaid adult dental benefit scope — Florida's own statement of what dental care adult Medicaid members receive; reviewed 2026-08-26
Florida publishes its Medicaid dental reimbursement rates in Florida Medicaid Dental General Services Fee Schedule. Those rates are what Florida 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 Florida reimbursement figure cannot answer what a filling or a crown would cost you. It does answer what Florida 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 Florida.
- Select Florida in Medicaid.gov’s state profiles, then confirm adult and child dental benefits in the state program documents.
- Separate federal rules from Florida-specific rules.
- Ask the provider to explain any conflict in writing.
Red flags
- A generic fifty-state chart replacing Florida primary material
- No license or designation verification
- Pressure to act before written terms are supplied
Adult and child dental benefits are set differently in Florida. 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. Florida operates an emergency-only adult dental benefit for adults aged 21 and over. In the state's own words: "Medicaid reimburses for acute emergency dental procedures to alleviate pain or infection, dentures and denture-related procedures for recipients 21 years and older including: Full dentures and partial dentures; Incision and drainage of an abscess; Radiographs necessary to make a diagnosis; Problem-focused oral evaluation." Confirm your own category before booking, because Florida eligibility groups can differ. Verified 2026-08-26.
Quick checklist
- Identify the person, service, and jurisdiction involved in Florida.
- Select Florida in Medicaid.gov’s state profiles, then confirm adult and child dental benefits in the state program documents.
- Separate federal rules from Florida-specific rules.
- Ask the provider to explain any conflict in writing.
Red flags
- A stale screenshot used as the only evidence
- No distinction between federal and Florida requirements
- A recommendation based only on advertising position
For “What should I confirm before booking Medicaid dental care in Florida?,” In Florida, verify the rule or credential through Medicaid.gov’s Florida profile and the current Florida 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
- Write the Florida question in one sentence.
- Select Florida 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 Florida claim with no source date
- A provider who will not identify the governing authority
- A price, deadline, or eligibility statement presented as universal
For “How do prior authorization and managed-care rules affect Florida dental access?,” A current Florida answer starts at Medicaid.gov’s Florida profile and the current Florida 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
- Write the Florida question in one sentence.
- Select Florida 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 Florida 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 Florida?,” For Florida, begin with Medicaid.gov’s Florida profile and the current Florida Medicaid dental program materials; it is the correct authority path for this page’s decision. Do not advance until the evidence file covers child EPSDT obligations, optional adult coverage, covered service categories, prior authorization, managed-care network rules, and current state contacts. Find a Provider routes to the canonical destination for current local options and verification.
Quick checklist
- Identify the person, service, and jurisdiction involved in Florida.
- Select Florida in Medicaid.gov’s state profiles, then confirm adult and child dental benefits in the state program documents.
- Separate federal rules from Florida-specific rules.
- Ask the provider to explain any conflict in writing.
Red flags
- A generic fifty-state chart replacing Florida primary material
- No license or designation verification
- Pressure to act before written terms are supplied
Need help applying this guide?
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- Georgia Medicaid Dental Coverage Guide
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