South Carolina Medicaid Dental Coverage Guide
South Carolina Medicaid Dental Coverage Guide: verify the South Carolina authority path, document the current rule or credential, compare written provider terms, and continue through Find a Provider only after the evidence check.
South Carolina Medicaid Dental Coverage Guide: verify the South Carolina authority path, document the current rule or credential, compare written provider terms, and continue through Find a Provider only after the evidence check. South Carolina Medicaid pays a dentist $55.00.
What this page recommends
South Carolina Medicaid Dental Coverage Guide: verify the South 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.
South Carolina Medicaid dental reimbursement rates on this page are taken from South Carolina Healthy Connections Medicaid Dental Fee Schedule, published by South Carolina Department of 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. South Carolina operates a limited adult dental benefit for adults 21 and over; children's dental care is required federally under EPSDT. Verified 2026-08-26.
South Carolina Medicaid dental reimbursement: what the program pays a dentist, not what a patient pays
| Procedure (CDT code) | What South Carolina Medicaid pays the dentist | Rate basis |
|---|---|---|
| Cleaning (prophylaxis), adult (CDT D1110) | South Carolina Medicaid pays a dentist $55.00 | State reimbursement, effective 2026-01-01 |
| Periodic oral exam (CDT D0120) | South Carolina Medicaid pays a dentist $28.00 | State reimbursement, effective 2026-01-01 |
| Root canal, molar tooth (CDT D3330) | South Carolina Medicaid pays a dentist $600.00 | State reimbursement, effective 2026-01-01 |
| Extraction, erupted tooth (simple) (CDT D7140) | South Carolina Medicaid pays a dentist $144.00 | State reimbursement, effective 2026-01-01 |
| Comprehensive oral exam (CDT D0150) | South Carolina Medicaid pays a dentist $49.00 | State reimbursement, effective 2026-01-01 |
| Cleaning (prophylaxis), child (CDT D1120) | South Carolina Medicaid pays a dentist $38.00 | State reimbursement, effective 2026-01-01 |
| Fluoride varnish (paediatric preventive) (CDT D1206) | South Carolina Medicaid pays a dentist $19.00 | State reimbursement, effective 2026-01-01 |
| Sealant, per tooth (paediatric preventive) (CDT D1351) | South Carolina Medicaid pays a dentist $33.00 | State reimbursement, effective 2026-01-01 |
| Amalgam filling, one surface (CDT D2140) | South Carolina Medicaid pays a dentist $65.00 | State reimbursement, effective 2026-01-01 |
| Composite filling, one surface, posterior (CDT D2391) | South Carolina Medicaid pays a dentist $117.00 | State reimbursement, effective 2026-01-01 |
| Root canal, anterior tooth (CDT D3310) | South Carolina Medicaid pays a dentist $440.00 | State reimbursement, effective 2026-01-01 |
| Root canal, premolar tooth (CDT D3320) | South Carolina Medicaid pays a dentist $501.00 | State reimbursement, effective 2026-01-01 |
| Complete denture, upper (CDT D5110) | South Carolina Medicaid pays a dentist $720.00 | State reimbursement, effective 2026-01-01 |
| Complete denture, lower (CDT D5120) | South Carolina Medicaid pays a dentist $720.00 | State reimbursement, effective 2026-01-01 |
| Surgical extraction, erupted tooth (CDT D7210) | South Carolina Medicaid pays a dentist $144.00 | 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
- South Carolina Healthy Connections Medicaid Dental Fee Schedule — Official South Carolina Medicaid dental fee schedule: amounts the state pays a dental provider per CDT procedure. Not consumer prices.; reviewed 2026-08-26
- South Carolina Medicaid adult dental benefit scope — South Carolina's own statement of what dental care adult Medicaid members receive; reviewed 2026-08-26
South Carolina publishes its Medicaid dental reimbursement rates in South Carolina Healthy Connections Medicaid Dental Fee Schedule. Those rates are what South 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 South Carolina reimbursement figure cannot answer what a filling or a crown would cost you. It does answer what South Carolina Medicaid will pay a dentist who accepts it. The figures on this page were retrieved 2026-08-26.
Quick checklist
- Record the event date and the decision deadline for the South Carolina issue.
- Select South Carolina 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 South Carolina requirements
- A recommendation based only on advertising position
Adult and child dental benefits are set differently in South 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. South Carolina operates a limited adult dental benefit for adults aged 21 and over. In the state's own words: "Adult Preventive Dental Benefit (age >21 years): Medically necessary diagnostic; preventive; restorative; dental extractions; and adjunctive services with specific policy limitations documented in Appendix B. These services, except diagnostic and adjunctive, are subject to a maximum of $1,000 per state fiscal year (SFY)." Confirm your own category before booking, because South Carolina eligibility groups can differ. Verified 2026-08-26.
Quick checklist
- Write the South Carolina question in one sentence.
- Select South 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 South Carolina requirements
- A recommendation based only on advertising position
For “What should I confirm before booking Medicaid dental care in South Carolina?,” The controlling verification path for South Carolina runs through Medicaid.gov’s South Carolina profile and the current South 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
- Record the event date and the decision deadline for the South Carolina issue.
- Select South Carolina 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 South Carolina requirements
- A recommendation based only on advertising position
For “How do prior authorization and managed-care rules affect South Carolina dental access?,” Treat Medicaid.gov’s South Carolina profile and the current South Carolina Medicaid dental program materials as the source-of-record pathway for this South Carolina 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
- Write the South Carolina question in one sentence.
- Select South 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
- An authority link that does not identify South Carolina or the topic
- A summary that hides exceptions
- A provider answer that changes when you ask for documentation
For “When should I use Find a Provider for Medicaid dental care in South Carolina?,” Use Medicaid.gov’s South Carolina profile and the current South Carolina Medicaid dental program materials as the first verification layer for South Carolina, then document what you checked and when. The practical review is incomplete until it addresses child EPSDT obligations, optional adult coverage, covered service categories, prior authorization, managed-care network rules, and current state contacts. If the rule or provider fit remains unclear, use Find a Provider for the nearest canonical next step.
Quick checklist
- Name the exact South Carolina decision and the date that could change it.
- Select South 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 stale screenshot used as the only evidence
- No distinction between federal and South Carolina requirements
- A recommendation based only on advertising position
Need help applying this guide?
- Rhode Island Medicaid Dental Coverage Guide
- South Dakota Medicaid Dental Coverage Guide
- Neuropsychological Evaluation Access in South Carolina
- South Carolina Comparative or Contributory Negligence Rules
- South Carolina Dental Insurance Marketplace Guide
- South Carolina Personal Injury Statute of Limitations
- Telehealth TRT Rules in South Carolina
- TRT Legality and Prescribing Rules in South Carolina
- USCIS Civil Surgeons in South Carolina