Montana Medicaid Dental Coverage Guide
Montana Medicaid Dental Coverage Guide: verify the Montana authority path, document the current rule or credential, compare written provider terms, and continue through Find a Provider only after the evidence check.
Montana Medicaid Dental Coverage Guide: verify the Montana authority path, document the current rule or credential, compare written provider terms, and continue through Find a Provider only after the evidence check. Montana Medicaid pays a dentist $59.28. Montana Medicaid pays a dentist $27.66.
What this page recommends
Montana Medicaid Dental Coverage Guide: verify the Montana 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.
Montana Medicaid dental reimbursement rates on this page are taken from Montana Healthcare Programs Dental Services Fee Schedule, published by Montana Department of Public Health and Human Services, and retrieved 2026-08-26. The schedule is effective 2026-01-01. 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. Montana operates a limited adult dental benefit for adults 21 and over; children's dental care is required federally under EPSDT. Verified 2026-08-26.
Montana Medicaid dental reimbursement: what the program pays a dentist, not what a patient pays
| Procedure (CDT code) | What Montana Medicaid pays the dentist | Rate basis |
|---|---|---|
| Cleaning (prophylaxis), adult (CDT D1110) | Montana Medicaid pays a dentist $59.28 | State reimbursement, effective 2026-01-01 |
| Periodic oral exam (CDT D0120) | Montana Medicaid pays a dentist $27.66 | State reimbursement, effective 2026-01-01 |
| Crown, porcelain/ceramic (CDT D2740) | Montana Medicaid pays a dentist $790.40 | State reimbursement, effective 2026-01-01 |
| Root canal, molar tooth (CDT D3330) | Montana Medicaid pays a dentist $553.28 | State reimbursement, effective 2026-01-01 |
| Extraction, erupted tooth (simple) (CDT D7140) | Montana Medicaid pays a dentist $86.94 | State reimbursement, effective 2026-01-01 |
| Comprehensive oral exam (CDT D0150) | Montana Medicaid pays a dentist $39.52 | State reimbursement, effective 2026-01-01 |
| Cleaning (prophylaxis), child (CDT D1120) | Montana Medicaid pays a dentist $39.52 | State reimbursement, effective 2026-01-01 |
| Fluoride varnish (paediatric preventive) (CDT D1206) | Montana Medicaid pays a dentist $23.71 | State reimbursement, effective 2026-01-01 |
| Sealant, per tooth (paediatric preventive) (CDT D1351) | Montana Medicaid pays a dentist $31.62 | State reimbursement, effective 2026-01-01 |
| Amalgam filling, one surface (CDT D2140) | Montana Medicaid pays a dentist $79.04 | State reimbursement, effective 2026-01-01 |
| Composite filling, one surface, posterior (CDT D2391) | Montana Medicaid pays a dentist $79.04 | State reimbursement, effective 2026-01-01 |
| Crown, porcelain fused to high noble metal (CDT D2750) | Montana Medicaid pays a dentist $869.44 | State reimbursement, effective 2026-01-01 |
| Crown, porcelain fused to predominantly base metal (CDT D2751) | Montana Medicaid pays a dentist $632.32 | State reimbursement, effective 2026-01-01 |
| Crown, full cast predominantly base metal (CDT D2791) | Montana Medicaid pays a dentist $553.28 | State reimbursement, effective 2026-01-01 |
| Root canal, anterior tooth (CDT D3310) | Montana Medicaid pays a dentist $403.10 | State reimbursement, effective 2026-01-01 |
| Root canal, premolar tooth (CDT D3320) | Montana Medicaid pays a dentist $454.48 | State reimbursement, effective 2026-01-01 |
| Complete denture, upper (CDT D5110) | Montana Medicaid pays a dentist $988.00 | State reimbursement, effective 2026-01-01 |
| Complete denture, lower (CDT D5120) | Montana Medicaid pays a dentist $988.00 | State reimbursement, effective 2026-01-01 |
| Bridge pontic, porcelain fused to high noble metal (CDT D6240) | Montana Medicaid pays a dentist $869.44 | State reimbursement, effective 2026-01-01 |
| Bridge retainer crown, porcelain fused to high noble metal (CDT D6750) | Montana Medicaid pays a dentist $948.48 | State reimbursement, effective 2026-01-01 |
| Surgical extraction, erupted tooth (CDT D7210) | Montana Medicaid pays a dentist $158.08 | State reimbursement, effective 2026-01-01 |
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
- Montana Healthcare Programs Dental Services Fee Schedule — Official Montana Medicaid dental fee schedule: amounts the state pays a dental provider per CDT procedure. Not consumer prices.; reviewed 2026-08-26
- Montana Medicaid adult dental benefit scope — Montana's own statement of what dental care adult Medicaid members receive; reviewed 2026-08-26
Montana publishes its Medicaid dental reimbursement rates in Montana Healthcare Programs Dental Services Fee Schedule. Those rates are what Montana 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 Montana reimbursement figure cannot answer what a filling or a crown would cost you. It does answer what Montana 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 Montana.
- Select Montana in Medicaid.gov’s state profiles, then confirm adult and child dental benefits in the state program documents.
- Separate federal rules from Montana-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 Montana requirements
- A recommendation based only on advertising position
Adult and child dental benefits are set differently in Montana. 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. Montana operates a limited adult dental benefit for adults aged 21 and over. In the state's own words: "Adults aged 21 and over are subject to an annual treatment services limit per benefit year. A benefit year begins on July 1 and ends the following June 30. Members determined categorically eligible for Aged, Blind, and Disabled (ABD) Medicaid per ARM 37.82.204 are not subject to the annual dental treatment services limit." Confirm your own category before booking, because Montana eligibility groups can differ. Verified 2026-08-26.
Quick checklist
- Name the exact Montana decision and the date that could change it.
- Select Montana 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 Montana 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 Montana?,” A current Montana answer starts at Medicaid.gov’s Montana profile and the current Montana 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 Montana question in one sentence.
- Select Montana 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 stale screenshot used as the only evidence
- No distinction between federal and Montana requirements
- A recommendation based only on advertising position
For “How do prior authorization and managed-care rules affect Montana dental access?,” For Montana, begin with Medicaid.gov’s Montana profile and the current Montana 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 Montana.
- Select Montana in Medicaid.gov’s state profiles, then confirm adult and child dental benefits in the state program documents.
- Separate federal rules from Montana-specific rules.
- Ask the provider to explain any conflict in writing.
Red flags
- A Montana claim with no source date
- A provider who will not identify the governing authority
- A price, deadline, or eligibility statement presented as universal
For “When should I use Find a Provider for Medicaid dental care in Montana?,” The defensible starting point in Montana is Medicaid.gov’s Montana profile and the current Montana 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 Montana issue.
- Select Montana 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 Montana requirements
- A recommendation based only on advertising position
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