Dental Fee Schedule

​​​​​​​​Excel Format
​PDF Format
2024 ​Dental Fee Schedule
2024 ​Dental Fee Schedule Effective 4/1/24 - 3/31/25

​2024 Adults Over 21 Emergent Schedule Effective 4/1/24 - 3/31/25

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

2024 Children​ 21 and Under​ ​Dental Schedule Effective 4/1/24 - 3/31/25
​2024 Dental Fee Schedule
​2024 Dent​al Fee Schedule Effective 1/1/24 - 3/31/24
2023 Dental Fee Schedule
​2023 De​ntal Fee Schedule Effective 4/1/23 - 3/31/24
​​2023 Dental Fee Schedule
​2023 De​ntal Fee Schedule Effective 1/1/23​ - 3/31/23
​​2022 Dental Fee Schedule ​​
​2022 Dental Fee Schedule Effective 4/1/22 - 3/31/23
2021 Dental Fee Schedule ​2021 Dental Fee Schedule 
​2021 Dental Fee Schedule 
​​2021 Dental Fee Schedule   Post Covid - Effective 01/01/21 - 3/31/21
2020 Dental Fee Schedule ​2020 Dental Fee Schedule    Covid Phase II Rates - Effective 7/01/20 - 12/31/20
Dental New Codes Dental New Codes  Effective 1//1/20 - 3/31/20
2020 Dental Fee Schedule ​2020 Dental Fee Schedule   Effective 4//1/20 - 3/31/21
2019 Dental Fee Schedule ​2019 Dental Fee Schedule 
​2018 Dental Fee Schedule ​2018 Dental Fee Schedule
2017 Dental Fee Schedule 2017 Dental Fee Schedule
2016 Dental Fee Schedule 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.

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