S5115 Medicaid reimbursement rates by state
Home care training, non-family; per 15 minutes. 7 state Medicaid programs publish a fee-for-service rate for S5115 at the agency level. Rates run from $4.35 in Arizona to $64.95 in Utah, with a median of $12.49.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 7
- Median rate
- $12.49units vary by state
- Highest
- $64.95Utah
- Medicare (non-facility)
- —not on the physician fee schedule
S5115 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.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| UtahAgency provider · Utah Medicaid (fee-for-service, Traditional plan) | $64.95⚠ over 3× mediansince 2022-01-01 | 15 min | $259.80 | Plans negotiate; applies out of network | — | Utah Medicaid Coverage and Reimbursement |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Alternative Care (AC, state-funded program for people 65+) | $20.82since 2026-01-01 | 15 min | $83.28 | Not classified | — | Long-Term Services and Supports Service |
| WashingtonAgency provider · Washington DDA waiver and state plan services (Basic Plus, Core, IFS, CIIBS, CP) | $18.75since 2021-07-01 | OF | — | Paid by the state, outside plans | — | DSHS ORM Home & Community Based Rates Hi |
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Assistive Daily Living Services (ADLS) Waiver (1915(c)) | $12.49since 2026-07-01 | 15 min | $49.96 | Not classified | — | South Dakota Medicaid Assistive Daily Li |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Aged and Disabled 1915(c) Waiver (ID.1076) | $9.89since 2026-07-01 | 15 min | $39.56 | Not classified | — | Aged and Disabled Waiver Services |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $7.00since 2003-09-01 | 15 min | $28.00 | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $4.35since 2026-10-01 | 15 min | $17.40 | Plans expected to pay at least this | — | AHCCCS Final FFS Home and Community Base |
Rates marked ⚠ are more than three times the median for the same unit; they are published as shown but often reflect an office (non-facility) fee or a different scope of service. 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 S5115?
It depends on the state. Of the 7 states with a published fee-for-service rate, the median is $12.49. Utah pays the most ($64.95 per 15 min) and Arizona the least ($4.35 per 15 min).
Which state pays the highest Medicaid rate for S5115?
Utah, at $64.95 per 15 min ($259.80 per hour), effective 2022-01-01.
Do managed-care plans pay the same rate for S5115?
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.