Texas Dentists Score a Win for Medicaid Reimbursement
Texas has approved a $140 million Medicaid dental reimbursement rate increase for a targeted list of frequently billed procedure codes, reversing earlier fee schedule changes. This strategic reallocation provides long-overdue financial relief for Medicaid dental providers across the state.
Texas dentists participating in Medicaid are getting a financial reprieve thanks to a $140 million boost in reimbursement rates for select dental procedure codes. Included in the state budget signed by Governor Greg Abbott, this targeted adjustment, titled the “Medicaid Dental Reimbursement Rate Reallocation,” rolls back the March 1, 2025, fee schedule and applies a uniform rate increase to high-volume and high-need services.
This change affects codes frequently used in daily practice, including exams (D0120, D0150), diagnostic imaging (D0210, D0272, D0330), fluoride applications, restorations, pulp therapy, extractions, stainless steel crowns, and moderate sedation. The Texas Dental Association, Texas Academy of Pediatric Dentistry, and engaged Medicaid providers worked tirelessly to secure this legislative win after the original Texas Health and Human Services Commission biennial review left many providers facing unsustainable reimbursement rates. The new rates are expected to take effect September 1. Designed to be revenue-neutral, this reallocation smartly directs limited funds where they will make the most impact, supporting critical services and improving practice sustainability. For dental providers, especially those serving rural or underserved populations, this is a meaningful step forward in preserving access to quality care while alleviating some of the cost pressures threatening the future of Medicaid dentistry in Texas. Click here to read more.
