Ohio Medicaid Dental Coverage Guide
Ohio Medicaid Dental Coverage Guide: verify the Ohio authority path, document the current rule or credential, compare written provider terms, and continue through Find a Provider only after the evidence check.
Ohio Medicaid Dental Coverage Guide: verify the Ohio authority path, document the current rule or credential, compare written provider terms, and continue through Find a Provider only after the evidence check. Ohio Medicaid pays a dentist $65.22. Ohio Medicaid pays a dentist $33.56.
What this page recommends
Ohio Medicaid Dental Coverage Guide: verify the Ohio 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.
Ohio Medicaid dental reimbursement rates on this page are taken from Ohio Medicaid Dental CDT Procedures fee schedule, published by Ohio Department of Medicaid, and retrieved 2026-08-26. The schedule is effective 2025-01-01. 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. Ohio operates a comprehensive adult dental benefit for adults 21 and over; children's dental care is required federally under EPSDT. Verified 2026-08-26.
Ohio Medicaid dental reimbursement: what the program pays a dentist, not what a patient pays
| Procedure (CDT code) | What Ohio Medicaid pays the dentist | Rate basis |
|---|---|---|
| Cleaning (prophylaxis), adult (CDT D1110) | Ohio Medicaid pays a dentist $65.22 | State reimbursement, effective 2025-01-01 |
| Periodic oral exam (CDT D0120) | Ohio Medicaid pays a dentist $33.56 | State reimbursement, effective 2025-01-01 |
| Crown, porcelain/ceramic (CDT D2740) | Ohio Medicaid pays a dentist $816.55 | State reimbursement, effective 2025-01-01 |
| Root canal, molar tooth (CDT D3330) | Ohio Medicaid pays a dentist $724.31 | State reimbursement, effective 2025-01-01 |
| Extraction, erupted tooth (simple) (CDT D7140) | Ohio Medicaid pays a dentist $113.36 | State reimbursement, effective 2025-01-01 |
| Comprehensive oral exam (CDT D0150) | Ohio Medicaid pays a dentist $50.35 | State reimbursement, effective 2025-01-01 |
| Cleaning (prophylaxis), child (CDT D1120) | Ohio Medicaid pays a dentist $38.22 | State reimbursement, effective 2025-01-01 |
| Fluoride varnish (paediatric preventive) (CDT D1206) | Ohio Medicaid pays a dentist $29.48 | State reimbursement, effective 2025-01-01 |
| Sealant, per tooth (paediatric preventive) (CDT D1351) | Ohio Medicaid pays a dentist $43.23 | State reimbursement, effective 2025-01-01 |
| Amalgam filling, one surface (CDT D2140) | Ohio Medicaid pays a dentist $78.60 | State reimbursement, effective 2025-01-01 |
| Composite filling, one surface, posterior (CDT D2391) | Ohio Medicaid pays a dentist $97.86 | State reimbursement, effective 2025-01-01 |
| Crown, porcelain fused to predominantly base metal (CDT D2751) | Ohio Medicaid pays a dentist $470.02 | State reimbursement, effective 2025-01-01 |
| Root canal, anterior tooth (CDT D3310) | Ohio Medicaid pays a dentist $473.22 | State reimbursement, effective 2025-01-01 |
| Root canal, premolar tooth (CDT D3320) | Ohio Medicaid pays a dentist $569.67 | State reimbursement, effective 2025-01-01 |
| Complete denture, upper (CDT D5110) | Ohio Medicaid pays a dentist $764.40 | State reimbursement, effective 2025-01-01 |
| Complete denture, lower (CDT D5120) | Ohio Medicaid pays a dentist $764.40 | State reimbursement, effective 2025-01-01 |
| Surgical extraction, erupted tooth (CDT D7210) | Ohio Medicaid pays a dentist $113.36 | State reimbursement, effective 2025-01-01 |
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
- Ohio Medicaid Dental CDT Procedures fee schedule — Official Ohio Medicaid dental fee schedule: amounts the state pays a dental provider per CDT procedure. Not consumer prices.; reviewed 2026-08-26
- Ohio Medicaid adult dental benefit scope — Ohio's own statement of what dental care adult Medicaid members receive; reviewed 2026-08-26
Ohio publishes its Medicaid dental reimbursement rates in Ohio Medicaid Dental CDT Procedures fee schedule. Those rates are what Ohio 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 Ohio reimbursement figure cannot answer what a filling or a crown would cost you. It does answer what Ohio Medicaid will pay a dentist who accepts it. The figures on this page were retrieved 2026-08-26.
Quick checklist
- Write the Ohio question in one sentence.
- Select Ohio 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 Ohio 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 Ohio. 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. Ohio operates a comprehensive adult dental benefit for adults aged 21 and over. In the state's own words: "Coverage policies for dental services are set forth in appendix A to this rule. [Appendix A, periodic oral evaluation:] Patient younger than 21: 1 per 180 days / Patient 21 or older: 1 per 365 days." Confirm your own category before booking, because Ohio eligibility groups can differ. Verified 2026-08-26.
Quick checklist
- Record the event date and the decision deadline for the Ohio issue.
- Select Ohio 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 Ohio requirements
- A recommendation based only on advertising position
For “What should I confirm before booking Medicaid dental care in Ohio?,” The defensible starting point in Ohio is Medicaid.gov’s Ohio profile and the current Ohio 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
- Name the exact Ohio decision and the date that could change it.
- Select Ohio 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 Ohio 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 Ohio dental access?,” Treat Medicaid.gov’s Ohio profile and the current Ohio Medicaid dental program materials as the source-of-record pathway for this Ohio question. The source review should produce a dated note covering child EPSDT obligations, optional adult coverage, covered service categories, prior authorization, managed-care network rules, and current state contacts. When facts or timing could change the answer, take the source record to a qualified provider.
Quick checklist
- Record the event date and the decision deadline for the Ohio issue.
- Select Ohio 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 Ohio 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 Ohio?,” A current Ohio answer starts at Medicaid.gov’s Ohio profile and the current Ohio 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 Ohio decision and the date that could change it.
- Select Ohio 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 stale screenshot used as the only evidence
- No distinction between federal and Ohio requirements
- A recommendation based only on advertising position
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