Vermont Medicaid Dental Coverage Guide
Vermont Medicaid Dental Coverage Guide: verify the Vermont authority path, document the current rule or credential, compare written provider terms, and continue through Find a Provider only after the evidence check.
Vermont Medicaid Dental Coverage Guide: verify the Vermont authority path, document the current rule or credential, compare written provider terms, and continue through Find a Provider only after the evidence check. Vermont Medicaid pays a dentist $75.75. Vermont Medicaid pays a dentist $39.75.
What this page recommends
Vermont Medicaid Dental Coverage Guide: verify the Vermont 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.
Vermont Medicaid dental reimbursement rates on this page are taken from Vermont Medicaid Fee Schedule - HCPCS (includes D codes), published by Vermont Department of Vermont Health Access (vtmedicaid.com), and retrieved 2026-08-26. Vermont publishes its schedule as a live database rather than a dated document; 97% of dental rows carry an effective date of 2023-07-01, and every row was last updated 2026-08-21. 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. Vermont operates a limited adult dental benefit for adults 21 and over; children's dental care is required federally under EPSDT. Verified 2026-08-26.
Vermont Medicaid dental reimbursement: what the program pays a dentist, not what a patient pays
| Procedure (CDT code) | What Vermont Medicaid pays the dentist | Rate basis |
|---|---|---|
| Cleaning (prophylaxis), adult (CDT D1110) | Vermont Medicaid pays a dentist $75.75 | State reimbursement, see the schedule for per-code effective dates |
| Periodic oral exam (CDT D0120) | Vermont Medicaid pays a dentist $39.75 | State reimbursement, see the schedule for per-code effective dates |
| Crown, porcelain/ceramic (CDT D2740) | Vermont Medicaid pays a dentist $891.75 | State reimbursement, see the schedule for per-code effective dates |
| Root canal, molar tooth (CDT D3330) | Vermont Medicaid pays a dentist $845.25 | State reimbursement, see the schedule for per-code effective dates |
| Extraction, erupted tooth (simple) (CDT D7140) | Vermont Medicaid pays a dentist $130.50 | State reimbursement, see the schedule for per-code effective dates |
| Comprehensive oral exam (CDT D0150) | Vermont Medicaid pays a dentist $97.50 | State reimbursement, see the schedule for per-code effective dates |
| Cleaning (prophylaxis), child (CDT D1120) | Vermont Medicaid pays a dentist $60.75 | State reimbursement, see the schedule for per-code effective dates |
| Fluoride varnish (paediatric preventive) (CDT D1206) | Vermont Medicaid pays a dentist $33.75 | State reimbursement, see the schedule for per-code effective dates |
| Sealant, per tooth (paediatric preventive) (CDT D1351) | Vermont Medicaid pays a dentist $43.50 | State reimbursement, see the schedule for per-code effective dates |
| Amalgam filling, one surface (CDT D2140) | Vermont Medicaid pays a dentist $101.25 | State reimbursement, see the schedule for per-code effective dates |
| Composite filling, one surface, posterior (CDT D2391) | Vermont Medicaid pays a dentist $125.25 | State reimbursement, see the schedule for per-code effective dates |
| Crown, porcelain fused to high noble metal (CDT D2750) | Vermont Medicaid pays a dentist $945.00 | State reimbursement, see the schedule for per-code effective dates |
| Crown, porcelain fused to predominantly base metal (CDT D2751) | Vermont Medicaid pays a dentist $833.25 | State reimbursement, see the schedule for per-code effective dates |
| Crown, full cast predominantly base metal (CDT D2791) | Vermont Medicaid pays a dentist $828.00 | State reimbursement, see the schedule for per-code effective dates |
| Root canal, anterior tooth (CDT D3310) | Vermont Medicaid pays a dentist $618.00 | State reimbursement, see the schedule for per-code effective dates |
| Root canal, premolar tooth (CDT D3320) | Vermont Medicaid pays a dentist $703.50 | State reimbursement, see the schedule for per-code effective dates |
| Complete denture, upper (CDT D5110) | Vermont Medicaid pays a dentist $1,251.75 | State reimbursement, see the schedule for per-code effective dates |
| Complete denture, lower (CDT D5120) | Vermont Medicaid pays a dentist $1,251.75 | State reimbursement, see the schedule for per-code effective dates |
| Bridge pontic, porcelain fused to high noble metal (CDT D6240) | Vermont Medicaid pays a dentist $895.50 | State reimbursement, see the schedule for per-code effective dates |
| Bridge retainer crown, porcelain fused to high noble metal (CDT D6750) | Vermont Medicaid pays a dentist $895.50 | State reimbursement, see the schedule for per-code effective dates |
| Surgical extraction, erupted tooth (CDT D7210) | Vermont Medicaid pays a dentist $216.75 | 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
- Vermont Medicaid Fee Schedule - HCPCS (includes D codes) — Official Vermont Medicaid dental fee schedule: amounts the state pays a dental provider per CDT procedure. Not consumer prices.; reviewed 2026-08-26
- Vermont Medicaid adult dental benefit scope — Vermont's own statement of what dental care adult Medicaid members receive; reviewed 2026-08-26
Vermont publishes its Medicaid dental reimbursement rates in Vermont Medicaid Fee Schedule - HCPCS (includes D codes). Those rates are what Vermont 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 Vermont reimbursement figure cannot answer what a filling or a crown would cost you. It does answer what Vermont Medicaid will pay a dentist who accepts it. The figures on this page were retrieved 2026-08-26.
Quick checklist
- Name the exact Vermont decision and the date that could change it.
- Select Vermont 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 Vermont 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 Vermont. 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. Vermont operates a limited adult dental benefit for adults aged 21 and over. In the state's own words: "The adult annual cap on dental expenditures was increased to $1,500 to coincide with the updated rates. Vermont Medicaid will cover emergency dental services for adults aged 21 and older after the annual $1,500 cap on expenditures has been met." Confirm your own category before booking, because Vermont eligibility groups can differ. Verified 2026-08-26.
Quick checklist
- Identify the person, service, and jurisdiction involved in Vermont.
- Select Vermont in Medicaid.gov’s state profiles, then confirm adult and child dental benefits in the state program documents.
- Separate federal rules from Vermont-specific rules.
- Ask the provider to explain any conflict in writing.
Red flags
- A generic fifty-state chart replacing Vermont 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 Vermont?,” In Vermont, verify the rule or credential through Medicaid.gov’s Vermont profile and the current Vermont 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 Vermont question in one sentence.
- Select Vermont 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 Vermont or the topic
- A summary that hides exceptions
- A provider answer that changes when you ask for documentation
For “How do prior authorization and managed-care rules affect Vermont dental access?,” Use Medicaid.gov’s Vermont profile and the current Vermont Medicaid dental program materials as the first verification layer for Vermont, 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 Vermont decision and the date that could change it.
- Select Vermont 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 Vermont requirements
- A recommendation based only on advertising position
For “When should I use Find a Provider for Medicaid dental care in Vermont?,” A current Vermont answer starts at Medicaid.gov’s Vermont profile and the current Vermont 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
- Identify the person, service, and jurisdiction involved in Vermont.
- Select Vermont in Medicaid.gov’s state profiles, then confirm adult and child dental benefits in the state program documents.
- Separate federal rules from Vermont-specific rules.
- Ask the provider to explain any conflict in writing.
Red flags
- An authority link that does not identify Vermont or the topic
- A summary that hides exceptions
- A provider answer that changes when you ask for documentation
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