North Carolina Medicaid Dental Coverage Guide
North Carolina Medicaid Dental Coverage Guide: verify the North Carolina authority path, document the current rule or credential, compare written provider terms, and continue through Find a Provider only after the evidence check.
North Carolina Medicaid Dental Coverage Guide: verify the North Carolina authority path, document the current rule or credential, compare written provider terms, and continue through Find a Provider only after the evidence check. North Carolina Medicaid pays a dentist $39.83.
What this page recommends
North Carolina Medicaid Dental Coverage Guide: verify the North Carolina 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.
North Carolina Medicaid dental reimbursement rates on this page are taken from NC Medicaid General Dental Fee Schedule, published by North Carolina Department of Health and Human Services, Division of Health Benefits, and retrieved 2026-08-26. NC Medicaid General Dental fee schedule, 'Last Revison Date: Apr 1, 2026' as printed in the file; each code carries its own effective date. 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. North Carolina operates a comprehensive adult dental benefit for adults 21 and over; children's dental care is required federally under EPSDT. Verified 2026-08-26.
North Carolina Medicaid dental reimbursement: what the program pays a dentist, not what a patient pays
| Procedure (CDT code) | What North Carolina Medicaid pays the dentist | Rate basis |
|---|---|---|
| Cleaning (prophylaxis), adult (CDT D1110) | North Carolina Medicaid pays a dentist $39.83 | State reimbursement, see the schedule for per-code effective dates |
| Periodic oral exam (CDT D0120) | North Carolina Medicaid pays a dentist $26.96 | State reimbursement, see the schedule for per-code effective dates |
| Root canal, molar tooth (CDT D3330) | North Carolina Medicaid pays a dentist $428.62 | State reimbursement, see the schedule for per-code effective dates |
| Extraction, erupted tooth (simple) (CDT D7140) | North Carolina Medicaid pays a dentist $66.44 | State reimbursement, see the schedule for per-code effective dates |
| Comprehensive oral exam (CDT D0150) | North Carolina Medicaid pays a dentist $46.65 | State reimbursement, see the schedule for per-code effective dates |
| Cleaning (prophylaxis), child (CDT D1120) | North Carolina Medicaid pays a dentist $28.46 | State reimbursement, see the schedule for per-code effective dates |
| Fluoride varnish (paediatric preventive) (CDT D1206) | North Carolina Medicaid pays a dentist $16.78 | State reimbursement, see the schedule for per-code effective dates |
| Sealant, per tooth (paediatric preventive) (CDT D1351) | North Carolina Medicaid pays a dentist $29.89 | State reimbursement, see the schedule for per-code effective dates |
| Amalgam filling, one surface (CDT D2140) | North Carolina Medicaid pays a dentist $78.12 | State reimbursement, see the schedule for per-code effective dates |
| Composite filling, one surface, posterior (CDT D2391) | North Carolina Medicaid pays a dentist $83.60 | State reimbursement, see the schedule for per-code effective dates |
| Root canal, anterior tooth (CDT D3310) | North Carolina Medicaid pays a dentist $296.52 | State reimbursement, see the schedule for per-code effective dates |
| Root canal, premolar tooth (CDT D3320) | North Carolina Medicaid pays a dentist $350.44 | State reimbursement, see the schedule for per-code effective dates |
| Complete denture, upper (CDT D5110) | North Carolina Medicaid pays a dentist $611.52 | State reimbursement, see the schedule for per-code effective dates |
| Complete denture, lower (CDT D5120) | North Carolina Medicaid pays a dentist $611.52 | State reimbursement, see the schedule for per-code effective dates |
| Surgical extraction, erupted tooth (CDT D7210) | North Carolina Medicaid pays a dentist $114.21 | State reimbursement, see the schedule for per-code effective dates |
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
- NC Medicaid General Dental Fee Schedule — Official North Carolina Medicaid dental fee schedule: amounts the state pays a dental provider per CDT procedure. Not consumer prices.; reviewed 2026-08-26
- North Carolina Medicaid adult dental benefit scope — North Carolina's own statement of what dental care adult Medicaid members receive; reviewed 2026-08-26
North Carolina publishes its Medicaid dental reimbursement rates in NC Medicaid General Dental Fee Schedule. Those rates are what North Carolina 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 North Carolina reimbursement figure cannot answer what a filling or a crown would cost you. It does answer what North Carolina Medicaid will pay a dentist who accepts it. The figures on this page were retrieved 2026-08-26.
Quick checklist
- Name the exact North Carolina decision and the date that could change it.
- Select North Carolina 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 North Carolina 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 North Carolina. 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. North Carolina operates a comprehensive adult dental benefit for adults aged 21 and over. In the state's own words: "Dental services are defined as diagnostic, preventive, or corrective procedures provided by or under the supervision of a dentist. This includes services to treat disease, maintain oral health, and treat injuries or impairments that may affect a beneficiary's oral or general health." Confirm your own category before booking, because North Carolina eligibility groups can differ. Verified 2026-08-26.
Quick checklist
- Name the exact North Carolina decision and the date that could change it.
- Select North Carolina 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 North Carolina 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 North Carolina?,” A current North Carolina answer starts at Medicaid.gov’s North Carolina profile and the current North Carolina 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 North Carolina question in one sentence.
- Select North Carolina 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 North Carolina 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 North Carolina dental access?,” For North Carolina, begin with Medicaid.gov’s North Carolina profile and the current North Carolina 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
- Write the North Carolina question in one sentence.
- Select North Carolina 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 North Carolina requirements
- A recommendation based only on advertising position
For “When should I use Find a Provider for Medicaid dental care in North Carolina?,” The controlling verification path for North Carolina runs through Medicaid.gov’s North Carolina profile and the current North Carolina 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 North Carolina.
- Select North Carolina in Medicaid.gov’s state profiles, then confirm adult and child dental benefits in the state program documents.
- Separate federal rules from North Carolina-specific rules.
- Ask the provider to explain any conflict in writing.
Red flags
- A North Carolina claim with no source date
- A provider who will not identify the governing authority
- A price, deadline, or eligibility statement presented as universal
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