Dental Fee Schedule

PDF / Excel 2025 Dental Fee Schedule ​​​Effective 4/1/25 - 3/31/26​​ 

PDF / Excel 2024 ​Dental Fe​e Schedule Effective 4/1/24 - 3/31/25​

​PDF            2024 Adults Over 21 Emergent S​chedule Effective 4/1/24 - 3/31/25 

PDF            2024 Adults Over 21 Expanded Schedule Effective 4/1/24 - 3/31/25 

PDF            2024 Children​ 21 and Under​ ​Dental Schedule Effective 4/1/24 - 3/31/25

PDF / Excel 2024 Dent​al Fee Schedule Effective 1/1/24 - 3/31/24 

PDF / Excel ​2023 De​ntal Fee Schedule Effective 4/1/23 - 3/31/24

PDF / Excel ​2023 De​ntal Fee Schedule Effective 1/1/23​ - 3/31/23 

PDF / Excel ​2022 Dental Fee Schedule Effective 4/1/22 - 3/31/23​ 

PDF / Excel ​2021 Dental Fee Schedule 

PDF / Excel 2021 Dental Fee Schedule Post Covid - Effective 01/01/21 - 3/31/21 

PDF / Excel ​2020 Dental Fee Schedule Covid Phase II Rates - Effective 7/01/20 - 12/31/20 

PDF / Excel Dental New Codes Effective 1/1/20 - 3/31/20 

PDF / Excel 2020 Dental Fee Schedule Effective 4/1/20 - 3/31/21 

PDF / Excel ​2019 Dental Fee Schedule 

PDF / Excel 2018 Dental Fee Schedule 

PDF / Excel ​2017 Dental Fee Schedule 

PDF / Excel 2016 Dental Fee Schedule 

Disclaimer: Note that the absence or presence of a reimbursement code and its associated allowance on these pages does not guarantee Medicaid coverage of the item or procedure. Please refer to the appropriate West Virginia Medicaid provider manual for coverage determination.