COVERAGE · TEXASSHEET 44 / 51

Texas, measured.

33,521 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 September 1, 2025 (view the source document). Practice costs index at 0.993 against the 1.000 national baseline.

EFFECTIVE SEPTEMBER 1, 2025 · FLOORS 24 OF 25 CODES Official schedule on file
33,521Licensed providers
24Medicaid fee rows
0.993Geo cost index / 1.000
$17.92 to $628.99Floor range
FEE SPECTRUM25 BENCHMARK CDT CODES

The Texas fee table

ProcedureMedicaid floorInsurer typicalPrivate-pay p50Private-pay p90
Diagnostic
Routine checkup (existing patient)$30.42$43$60$93
Comprehensive exam (new patient)$43.50$71$99$153
Full-mouth X-ray series$74.49$114$159$231
Bitewing X-rays (set of 4)$36.50$50$70$102
Panoramic X-ray$67.26$100$139$202
Emergency
Emergency visit for pain relief$17.92$104$144$223
Endodontics
Root canal, front tooth$358.68$679$943$1,462
Root canal, molar$628.99$915$1,271$1,970
Implants
Dental implant placementNo published floor$1,466$2,036$3,156
Oral surgery
Simple tooth extraction$67.55$140$194$301
Surgical tooth extraction$103.58$236$328$508
Orthodontics
Full braces treatment, adolescent$544.05$4,075$5,660$7,641
Periodontics
Deep cleaning below gumline (per quadrant)$53.75$182$253$392
Ongoing gum maintenance visit$35.83$114$159$246
Preventive
Adult teeth cleaning$57.87$75$104$161
Child teeth cleaning$38.75$57$79$122
Fluoride varnish treatment$21.04$36$50$78
Protective tooth sealant$29.78$40$55$85
Restorative
Metal filling (1 surface)$66.22$111$154$239
Tooth-colored filling, front tooth$79.94$140$194$301
Tooth-colored filling, back tooth (1 surface)$84.72$150$209$324
Tooth-colored filling, back tooth (2 surfaces)$111.04$179$248$384
Ceramic crown$252.25$1,001$1,390$2,154
Porcelain-on-metal crown$532$822$1,142$1,770
Crown foundation buildup$43$215$298$462

Floor. Official Texas Medicaid fee-for-service dental schedule, effective September 1, 2025. View the source document.

Bands. Modeled: the national median billed charge for each procedure, scaled by the Texas geographic cost index (0.993 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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