; and (B) by adding at the end the following new subsection: (uu) Specified average rate defined (1) In general For purposes of subsection (a)(13)(D), the term specified average rate means, with respect to a dental service furnished in a State, the average of the contracted rates (as defined in paragraph (2)) in effect during the 5-year period ending on the date such service is so furnished— (A) for such service furnished in such State (as determined by the State); or (B) for such service furnished in the United States (as determined by the Secretary); as selected by such State. (2) Contracted rate defined (A) In general For purposes of paragraph (1), the term contracted rate means, with respect to a dental service, a rate in effect between a health insurance issuer offering group or individual health insurance coverage or a group health plan (as such terms are defined in section 2791 of the Public Health Service Act) and a dentist with a contractual relationship in effect with such issuer or plan (as applicable) for furnishing such service under such coverage or plan (as applicable) that represents the total amount payable (including cost sharing) under such coverage or plan (as applicable) for such service so furnished. (B) Exclusion of self-insured group health plan rates For purposes of subparagraph (A), the term contracted rate shall not include a rate described in such subparagraph that is in effect between a self-insured group health plan and a dentist. . (2) Medicaid managed care plans Section 1932(f) of the Social Security Act ( 42 U.S.C. 1396u–2(f) ) is amended— (A) in the header, by striking primary care services and inserting certain services ; (B) by inserting or dental services after primary care services ; (C) by striking section 1902(a)(13)(C) and inserting subparagraph (C) or (D), respectively, of section 1902(a)(13)