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S5102 Medicaid reimbursement rates by state

Day care services, adult; per diem. 17 state Medicaid programs publish a fee-for-service rate for S5102 at the agency level. Rates run from $10.70 in Virginia to $116.59 in Maryland, with a median of $80.00.

Data as of 2026-10-05. Every rate links to the official document it came from.

States publishing
17
Median rate
$80.00units vary by state
Highest
$116.59Maryland
Medicare (non-facility)
—not on the physician fee schedule

S5102 rate in every state

One like-for-like fee-for-service rate per state, highest first. Units can differ between states; the per-hour column converts time-based units.

StateMedicaid rateUnitPer hourManaged-care plans% of MedicareSource
MarylandAny qualified provider (rate does not vary by provider) · Maryland Community First Choice, Community Personal Assistance Services and Home and Community-Based Options Waiver / Increased Community Services$116.59since 2024-07-01day—Paid by the state, outside plans—PT 04-25 Fiscal Year 2025 Rates for HCBO
OhioAny qualified provider (rate does not vary by provider) · Ohio Home Care Waiver (ODM)$106.26since 2026-04-17day—Plans negotiate; applies out of network—OAC 5160-46-06 (Register of Ohio final f
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Independent Care Waiver Program (adults with physical disabilities or brain injury)$100.72since 2024-07-01day—Paid by the state, outside plans—Part II Policies and Procedures: Indepen
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$99.49since 2025-07-01day—Paid by the state, outside plans—Rates for Adult Day Health Services (eff
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$96.93since 2026-10-01day—Plans expected to pay at least this—AHCCCS Final FFS Home and Community Base
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$87.00since 2025-01-01day—Not classified—NJMMIS Procedure Master Listing CPTHCPCS
WashingtonAny qualified provider (rate does not vary by provider) · Washington ALTSA adult day care and adult day health$86.01since 2026-07-01day—Paid by the state, outside plans—DSHS ORM All HCS Rates
ColoradoAny qualified provider (rate does not vary by provider) · Colorado HCBS waiver for persons with a brain injury (BI)$83.15since 2026-07-01day—Paid by the state, outside plans—EBD, CMHS, BI, CIH (effective July 1, 20
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Community Long Term Care waivers (Community Choices, HIV/AIDS, Mechanical Ventilator Dependent; 1915(c))$80.00since 2025-11-01day—Paid by the state, outside plans—SCDHHS HCBS Waivers Fee Schedule (Effect
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$76.27since 2026-10-01day—Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
IowaAny qualified provider (rate does not vary by provider) · Iowa HCBS AIDS/HIV 1915(c) waiver$52.51since 2025-08-01Full Day—Not classified—HCBS Habilitation and Waiver Upper Rate
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Adult Day Health Care Waiver (OAAS 1915(c) waiver)$47.35since 2023-11-12day—Paid by the state, outside plans—Adult Day Health Care Waiver services pr
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina CAP consumer-directed option (CAP/CD)$43.06since 2025-10-01day—Paid by the state, outside plans—NC Medicaid fee schedule 'CAP- Consumer
NevadaAny qualified provider (rate does not vary by provider) · Nevada HCBS Waiver for the Frail Elderly (provider types 48, 57 and 59, fee-for-service)$42.00since 2021-07-01day—Paid by the state, outside plans—Provider Type 48 Home and Community Base
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania OBRA Waiver (adults with developmental physical disabilities)$37.51since 2026-07-011/2 Day—Not classified—OLTL Home and Community Based Waiver Ser
FloridaAgency provider · Florida iBudget waiver for people with developmental disabilities (APD)$22.71since 2026-07-01hour$22.71Paid by the state, outside plans—Florida Medicaid Developmental Disabilit
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$10.70since 2026-07-01day—Plans must pay at least this—DMAS procedure fee file hcpcmedical.csv

Rates are per the unit shown for each state; units can differ between states. Medicare amounts are computed from the CMS relative value file and locality cost indices with the CMS formula; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Frequently asked questions

What does Medicaid pay for S5102?

It depends on the state. Of the 17 states with a published fee-for-service rate, the median is $80.00. Maryland pays the most ($116.59 per day) and Virginia the least ($10.70 per day).

Which state pays the highest Medicaid rate for S5102?

Maryland, at $116.59 per day, effective 2024-07-01.

Do managed-care plans pay the same rate for S5102?

Not necessarily. Each state's plan contracts decide whether plans must pay at least the fee-for-service rate, pay a state-set rate, or negotiate their own. The table shows the rule for each state, cited to the contract or statute.

Related Other home & community services codes

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