Dental procedure costs in Pennsylvania

PA Adult Medicaid coverage: limited · RPP 97.7

Pennsylvania dental cost overview

Pennsylvania Medicaid covers limited adult dental services (preventive + basic restorative).

Pennsylvania's state-level cost of living, captured by the Bureau of Economic Analysis Regional Price Parities at 97.7 (US average = 100), drives private-market dental fees up or down from the national baseline. Pennsylvania sits close to the national average — the local private-market price for most procedures lands within a few percent of the ADA HPI national midpoint.

Pennsylvania Medicaid covers 23 of the 62 procedures we track for adults, with an average reimbursement of $48 per procedure across covered services. The full procedure-by-procedure table is below.

Reimbursement rates and coverage tiers are set state-by-state and shift annually as legislatures rebalance Medicaid budgets, so the figures shown here for Pennsylvania reflect the most recent published schedule we have on file — always confirm with the state Medicaid office or your dental provider before scheduling. Adult coverage tiers in our framework correspond to common cost-sharing patterns: emergency-only states pay only for pain relief, extractions, or trauma; limited-coverage states add cleanings and fillings; comprehensive states pay for crowns, bridges, and dentures. Pediatric coverage is more uniform across states because EPSDT (Early and Periodic Screening, Diagnostic, and Treatment) federally mandates a baseline of children's dental services, so family-budget planning for kids in Pennsylvania should be straightforward.

limited
Adult Medicaid coverage tier
23/62
Procedures covered for adults
$48
Avg. Medicaid reimbursement
$805
Avg. private-market estimate

Pennsylvania dental cost table

All procedures shown below are organized by clinical category. Click any procedure for cross-state comparison.

Adjunctive

Cosmetic

Procedure CDT Medicaid fee Private estimate
External Bleaching - Per Arch (Office) D9972 Not covered $441
Internal Bleaching - Per Tooth D9974 Not covered $311

Crowns

Procedure CDT Medicaid fee Private estimate
Crown - Full Cast High Noble Metal D2790 Not covered $1,239
Crown - Porcelain Fused to High Noble Metal D2750 Not covered $1,239
Crown - Porcelain Fused to Noble Metal D2752 Not covered $1,170
Crown - Porcelain/Ceramic D2740 Not covered $1,307

Diagnostic

Endodontics

Procedure CDT Medicaid fee Private estimate
Endodontic Therapy - Anterior Tooth D3310 Not covered $1,050
Endodontic Therapy - Bicuspid Tooth D3320 Not covered $1,223
Endodontic Therapy - Molar Tooth D3330 Not covered $1,454
Retreatment of Previous Root Canal - Anterior D3346 Not covered $1,257
Retreatment of Previous Root Canal - Molar D3348 Not covered $1,574
Therapeutic Pulpotomy D3220 Not covered $171

Implants

Procedure CDT Medicaid fee Private estimate
Abutment-Supported Porcelain/Ceramic Crown D6058 Not covered $1,600
Custom Fabricated Abutment D6057 Not covered $675
Implant-Supported Porcelain/Ceramic Crown D6065 Not covered $1,837
Prefabricated Abutment D6056 Not covered $494
Surgical Placement of Implant Body D6010 Not covered $2,304

Oral Surgery

Procedure CDT Medicaid fee Private estimate
Extraction of Erupted Tooth D7140 $65 $208
Incisional Biopsy of Oral Tissue - Soft D7286 Not covered $331
Removal of Impacted Tooth - Bony with Complication D7241 Not covered $490
Removal of Impacted Tooth - Completely Bony D7240 Not covered $423
Removal of Impacted Tooth - Partially Bony D7230 Not covered $361
Removal of Impacted Tooth - Soft Tissue D7220 Not covered $257
Surgical Removal of Erupted Tooth D7210 Not covered $315
Surgical Removal of Residual Tooth Roots D7250 Not covered $388

Orthodontics

Procedure CDT Medicaid fee Private estimate
Comprehensive Orthodontic Treatment - Adolescent D8080 Not covered $5,924
Comprehensive Orthodontic Treatment - Adult D8090 Not covered $6,351

Periodontics

Procedure CDT Medicaid fee Private estimate
Gingivectomy or Gingivoplasty - Four+ Teeth D4210 Not covered $447
Periodontal Maintenance D4910 Not covered $164
Periodontal Scaling - 1-3 Teeth Per Quadrant D4342 Not covered $192
Periodontal Scaling - Four+ Teeth Per Quadrant D4341 Not covered $274

Preventive

Procedure CDT Medicaid fee Private estimate
Prophylaxis - Adult D1110 $41 $120
Prophylaxis - Child D1120 $32 $84
Sealant - Per Tooth D1351 $23 $66
Topical Application of Fluoride D1208 $15 $42
Topical Application of Fluoride Varnish D1206 $16 $45

Prosthodontics

Procedure CDT Medicaid fee Private estimate
Complete Denture - Mandibular D5120 Not covered $1,913
Complete Denture - Maxillary D5110 Not covered $1,913
Mandibular Partial Denture - Cast Metal Framework D5214 Not covered $2,058
Maxillary Partial Denture - Cast Metal Framework D5213 Not covered $2,058
Pontic - Porcelain Fused to High Noble Metal D6240 Not covered $1,239
Retainer Crown - Porcelain Fused to High Noble Metal D6750 Not covered $1,239

Analysis: paying for dental care in Pennsylvania

Adults on Medicaid in Pennsylvania have access to a limited adult dental benefit. The catch is finding a dentist who takes Medicaid: state Medicaid programs typically reimburse around 30–50% of private-market fees, which means many private practices either don't accept Medicaid or accept a limited number of Medicaid patients. The state Medicaid agency maintains a directory of participating dentists; FQHCs (Federally Qualified Health Centers) and dental school clinics are typically the highest-volume Medicaid-accepting providers in any market.

For uninsured adults, the gap between the cheapest provider category (FQHC, dental school) and a private general dentist is typically 30–50% on routine procedures, much wider on specialty work like crowns and implants. Always ask for a written treatment estimate that itemizes diagnostic codes (X-rays, exams) separately from the procedure fee — bundled estimates can mask significant variation in how providers price the same work.

The state's overall cost-of-living position (BEA RPP 97.7) gives you a quick mental adjustment for the ADA HPI national private-market averages: multiply the national figure by 0.98 for the Pennsylvania state-level estimate. The actual price you'll see at a specific dentist will vary — urban downtowns tend to be 15–25% above the state RPP, rural areas 10–15% below — but the state RPP is a good first-pass estimate.

Related

Compare across all states

Pennsylvania Medicaid dental fee schedule (state Medicaid agency, current 2026 Q1).

Source: MACPAC, Medicaid Coverage of Dental Benefits for Adults (compendium).

Source: BEA Regional Price Parities, by State (most recent annual release).

Read our methodology — how this data is sourced, computed, and verified.

Source: Pennsylvania Medicaid dental fee schedule (current 2026 Q1). Private-market estimates: ADA HPI Survey of Dental Fees (2024) adjusted by BEA Regional Price Parities. Disclaimer: Estimates only — actual fees depend on the specific dentist, geographic submarket, and clinical complexity. State coverage policy can change. This site does not provide medical or dental advice.