COVERAGE · TENNESSEESHEET 43 / 51

Tennessee, measured.

6,617 licensed dental providers on record, refreshed monthly from the federal registry. The Medicaid floors below come from the official state fee-for-service schedule, effective January 1, 2026 (view the source document). Practice costs index at 0.941 against the 1.000 national baseline.

EFFECTIVE JANUARY 1, 2026 · FLOORS 21 OF 25 CODES Official schedule on file
6,617Licensed providers
21Medicaid fee rows
0.941Geo cost index / 1.000
$22.55 to $708.37Floor range
FEE SPECTRUM25 BENCHMARK CDT CODES

The Tennessee fee table

ProcedureMedicaid floorInsurer typicalPrivate-pay p50Private-pay p90
Diagnostic
Routine checkup (existing patient)$26.11$40$56$87
Comprehensive exam (new patient)$30.71$68$94$146
Full-mouth X-ray series$63.64$109$151$219
Bitewing X-rays (set of 4)$28.56$48$66$96
Panoramic X-ray$50.72$95$132$191
Emergency
Emergency visit for pain relief$51.18$98$136$211
Endodontics
Root canal, front tooth$449.92$644$894$1,386
Root canal, molar$708.37$867$1,204$1,866
Implants
Dental implant placementNo published floor$1,389$1,929$2,990
Oral surgery
Simple tooth extraction$70.93$132$183$284
Surgical tooth extraction$137.70$224$311$482
Orthodontics
Full braces treatment, adolescentNo published floor$3,862$5,364$7,241
Periodontics
Deep cleaning below gumline (per quadrant)$144.78$173$240$372
Ongoing gum maintenance visit$77.02$109$151$234
Preventive
Adult teeth cleaning$45.63$71$99$153
Child teeth cleaningNo published floor$54$75$116
Fluoride varnish treatment$22.55$34$47$73
Protective tooth sealantNo published floor$37$52$81
Restorative
Metal filling (1 surface)$66.62$105$146$226
Tooth-colored filling, front tooth$66.62$132$183$284
Tooth-colored filling, back tooth (1 surface)$66.62$143$198$307
Tooth-colored filling, back tooth (2 surfaces)$79.93$169$235$364
Ceramic crown$575.82$948$1,317$2,041
Porcelain-on-metal crown$575.82$779$1,082$1,677
Crown foundation buildup$149.04$203$282$437

Floor. Official Tennessee Medicaid fee-for-service dental schedule, effective January 1, 2026. View the source document.

Bands. Modeled: the national median billed charge for each procedure, scaled by the Tennessee geographic cost index (0.941 against a 1.000 national baseline), with the insurer-typical amount modeled at roughly 72 percent of area billed charges. Estimates, not quotes.

HOW TO READ IT

Reading this table

The Medicaid floor is the exact fee on the state schedule: the lowest rate a practice accepts for that procedure, and the anchor of the revenue spectrum. Insurer typical models what a commercial plan tends to allow, about 72 percent of area billed charges. Private-pay p50 and p90 are modeled billed-charge bands: the national median scaled by the state cost index, and the top of the usual range. Where a practice actually lands depends on its payer mix. The floor is owned data; the bands are estimates.

CROSS REFERENCE
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