Dental Fee Schedules

Dental Fee Schedules	Current Schedule Effective Date	Previous Schedule Effective Date	Archives
Adult Denture Program Fee Schedule	08/30/23 PDF	01/01/16 PDF	(effective 07/01/14) (effective 08/01/13) (effective 07/01/12) (effective 11/01/07) (effective 11/01/06) (effective 09/01/04) (effective 08/01/03) (effective 05/01/03) (effective 07/05/02) (effective 01/21/01) (effective 07/01/00) (effective 01/01/95)
Adult ICF/IID Dental Program Fee Schedule	04/21/25 PDF	05/01/24 PDF	(effective 12/28/23) (effective 11/02/23) (effective 08/30/23) (effective 05/01/23)
Adult Waiver Dental Program Fee Schedule	04/21/25 PDF	05/01/24 PDF	(effective 12/28/23) (effective 11/02/23) (effective 08/30/23) (effective 05/01/23) (effective 12/01/22) (effective 07/01/22)
EPSDT Dental Program Fee Schedule	04/21/25 PDF	05/01/24 PDF	(effective 12/28/23) (effective 11/02/23) (effective 08/30/23) (effective 05/01/23) (effective 07/01/19) (effective 07/01/14) (effective 08/01/13) (effective 01/01/13) (effective 07/01/12) (effective 01/01/11) (effective 08/01/10) (effective 01/22/10) (effective 01/01/09) (effective 12/24/08) (effective 11/01/07) (effective 01/01/07) (effective 11/01/06) (effective 11/01/05) (effective 09/01/04) (effective 05/01/03) (effective 07/06/02) (effective 01/21/01) (effective 07/01/00) (effective 01/01/95)

Dental Fee Schedules Print