S5125 Medicaid reimbursement rates by state
Attendant care services; per 15 minutes. 34 state Medicaid programs publish a fee-for-service rate for S5125 at the aide level. Rates run from $1.18 in Virginia to $3,500.00 in South Dakota, with a median of $6.31.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 34
- Median rate
- $6.31units vary by state
- Highest
- $3,500.00South Dakota
- Medicare (non-facility)
- —not on the physician fee schedule
S5125 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 |
|---|---|---|---|---|---|---|
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Family Support 360 Waiver (1915(c) developmental disabilities, in-home supports) | $3,500.00since 2025-07-01 | month | — | Not classified | — | South Dakota Medicaid Family Support 360 |
| IllinoisAide or attendant (HHA, CNA, PCA, home care aide) · Illinois Persons with Brain Injury waiver (DHS-DRS Home Services Program, IL.0329) | $18.75since 2025-07-01 | hour | $18.75 | Plans must pay at least this | — | Calendar Year 2025 HCBS Payment Disclosu |
| MinnesotaAide or attendant (HHA, CNA, PCA, home care aide) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $18.43since 2015-07-01 | 15 min | $73.72 | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| HawaiiAide or attendant (HHA, CNA, PCA, home care aide) · Hawaii DOH DDD Medicaid I/DD waiver (1915(c) HI.0013) | $17.37since 2025-07-01 | 15 min | $69.48 | Paid by the state, outside plans | — | DOH DDD I/DD Waiver Schedule of Rates (m |
| Rhode IslandAide or attendant (HHA, CNA, PCA, home care aide) · Rhode Island Medicaid home care and personal care (fee-for-service) | $11.33since 2026-10-01 | — | — | Plans must pay at least this | — | Home Health Agency Rates 10/1/2026 (Prov |
| MissouriAide or attendant (HHA, CNA, PCA, home care aide) · Missouri DD Comprehensive Waiver (DMH Division of DD, 1915(c)) | $10.88since 2024-07-01 | 15 min | $43.52 | Paid by the state, outside plans | — | MO HealthNet fee schedule: Comprehensive |
| North DakotaAny qualified provider (rate does not vary by provider) · North Dakota 1915(c) Traditional IID/DD HCBS Waiver (ND.0037; DD payment system) | $10.43since 2026-07-01 | 15 min | $41.72 | Not classified | — | DD Rate Guidelines - 2026-2027 Salary Re |
| OhioAide or attendant (HHA, CNA, PCA, home care aide) · Ohio Home Care Waiver (ODM) | $9.81since 2024-01-01 | 15 min | $39.24 | Plans negotiate; applies out of network | — | OAC 5160-46-06.1 (Register of Ohio final |
| AlaskaAgency provider · Alaska Personal Care Services and Community First Choice (State Plan, SDS) | $9.30since 2026-07-01 | 15 min | $37.20 | Not classified | — | Chart of Personal Care Services and Comm |
| MontanaAide or attendant (HHA, CNA, PCA, home care aide) · Montana Big Sky Waiver for elderly and physically disabled adults (1915(c), fee-for-service) | $9.19since 2025-07-01 | 15 min | $36.76 | Not classified | — | Montana Healthcare Programs fee schedule |
| IndianaAgency provider · Indiana Money Follows the Person (Health & Wellness / A&D track) | $8.59since 2023-07-01 | 15 min | $34.36 | Paid by the state, outside plans | — | IHCP Professional Fee Schedule (Last Upd |
| New MexicoAide or attendant (HHA, CNA, PCA, home care aide) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $8.42since 2024-07-01 | 15 min | $33.68 | Plans must pay at least this | — | New Mexico Medicaid Fee for Service HCPC |
| UtahAide or attendant (HHA, CNA, PCA, home care aide) · Utah Physical Disabilities 1915(c) waiver | $7.22since 2026-07-01 | 15 min | $28.88 | Paid by the state, outside plans | — | Utah Medicaid Coverage and Reimbursement |
| North CarolinaAide or attendant (HHA, CNA, PCA, home care aide) · North Carolina CAP consumer-directed option (CAP/CD) | $7.03since 2026-08-01 | 15 min | $28.12 | Paid by the state, outside plans | — | NC Medicaid fee schedule 'CAP- Consumer |
| IowaAide or attendant (HHA, CNA, PCA, home care aide) · Iowa HCBS AIDS/HIV 1915(c) waiver | $6.69since 2026-10-01 | 15 min | $26.76 | Not classified | — | HCBS Habilitation and Waiver Fee Schedul |
| OklahomaAide or attendant (HHA, CNA, PCA, home care aide) · Oklahoma Medically Fragile 1915(c) waiver | $6.58since 2024-10-01 | 15 min | $26.32 | Paid by the state, outside plans | — | Reimbursement Rates for Services, Medica |
| KentuckyAide or attendant (HHA, CNA, PCA, home care aide) · Kentucky Michelle P. 1915(c) waiver | $6.36since 2025-01-01 | 15 min | $25.44 | Paid by the state, outside plans | — | DMS Home and Community Based Services Wa |
| NevadaAide or attendant (HHA, CNA, PCA, home care aide) · Nevada HCBS Waiver for Persons with Physical Disabilities (provider type 58, fee-for-service) | $6.25since 2024-01-01 | 15 min | $25.00 | Paid by the state, outside plans | — | Provider Type 58 Home and Community Base |
| ArizonaAide or attendant (HHA, CNA, PCA, home care aide) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $6.19since 2026-10-01 | 15 min | $24.76 | Plans expected to pay at least this | — | AHCCCS Final FFS Home and Community Base |
| IdahoAgency provider · Idaho Aged and Disabled 1915(c) Waiver (ID.1076) | $6.11since 2026-07-01 | 15 min | $24.44 | Not classified | — | Aged and Disabled Waiver Services |
| WashingtonAide or attendant (HHA, CNA, PCA, home care aide) · Washington ALTSA home and community services (other HCBS) | $6.01since 2026-07-01 | 1/4 Hour | — | Paid by the state, outside plans | — | DSHS ORM All HCS Rates |
| New JerseyAide or attendant (HHA, CNA, PCA, home care aide) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $5.62since 2025-01-01 | 15 min | $22.48 | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| ArkansasAide or attendant (HHA, CNA, PCA, home care aide) · Arkansas ARChoices in Homecare 1915(c) waiver | $5.12since 2022-08-25 | 15 min | $20.48 | Paid by the state, outside plans | — | Arkansas Medicaid ARChoices Fee Schedule |
| AlabamaAide or attendant (HHA, CNA, PCA, home care aide) · Alabama Community Waiver Program (1115 demonstration with 1915(c)/1915(i) services; ADMH-DDD) | $5.00since 2020-12-17 | 15 min | — | Not classified | — | ADMH Community Waiver Program Rate Sheet |
| MississippiAide or attendant (HHA, CNA, PCA, home care aide) · Mississippi HCBS Intellectual Disabilities/Developmental Disabilities (ID/DD) 1915(c) waiver | $4.62since 2023-07-01 | 15 min | $18.48 | Paid by the state, outside plans | — | MS DOM ID/DD Waiver fee schedule (Intell |
| VermontAide or attendant (HHA, CNA, PCA, home care aide) · Vermont Attendant Services Program - Medicaid (self-directed attendant care) | $4.36since 2025-07-01 | 15 min | $17.44 | Not classified | — | DAIL Adult Services Division - Billing C |
| District of ColumbiaAide or attendant (HHA, CNA, PCA, home care aide) · DC Medicaid (DHCF) fee-for-service | $4.08since 2006-01-17 | 15 min | $16.32 | Not classified | — | REFRP00178CSV - Medical Fee Schedule Rep |
| South CarolinaAide or attendant (HHA, CNA, PCA, home care aide) · South Carolina Intellectual Disability and Related Disabilities (ID/RD) Waiver (SC.0237, DDSN-operated) | $4.07since 2025-11-01 | 15 min | $16.28 | Paid by the state, outside plans | — | SCDHHS HCBS Waivers Fee Schedule (Effect |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $4.02since 2009-01-01 | 15 min | $16.08 | Paid by the state, outside plans | — | ForwardHealth max fee schedule: School B |
| MaineAide or attendant (HHA, CNA, PCA, home care aide) · MaineCare (fee-for-service) | $3.85since 2026-01-01 | 15 min | $15.40 | Not classified | — | MaineCare Section 12 Consumer Directed A |
| WyomingSelf-directed worker (hired by the person or family) · Wyoming Community Choices Waiver (1915(c), elderly and physically disabled) | $3.80since 2023-04-01 | 15 min | $15.20 | Not classified | — | CCW Waiver Fee Schedule - Effective Apri |
| West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Intellectual/Developmental Disabilities 1915(c) Waiver (IDDW) | $3.38since 2025-10-01 | 15 min | $13.52 | Paid by the state, outside plans | — | BMS memo 'Rate Increases' (HCBS & PC Rat |
| LouisianaAide or attendant (HHA, CNA, PCA, home care aide) · Louisiana New Opportunities Waiver (NOW, OCDD/OIDD 1915(c) waiver for people with intellectual/developmental disabilities) | $3.30since 2026-10-01 | 15 min | $13.20 | Paid by the state, outside plans | — | New Opportunities Waiver rate and proced |
| VirginiaAide or attendant (HHA, CNA, PCA, home care aide) · Virginia Medicaid (fee-for-service, DMAS) | $1.18since 2003-07-01 | 15 min | $4.72 | Plans negotiate; applies out of network | — | 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 S5125?
It depends on the state. Of the 34 states with a published fee-for-service rate, the median is $6.31. South Dakota pays the most ($3,500.00 per month) and Virginia the least ($1.18 per 15 min).
Which state pays the highest Medicaid rate for S5125?
South Dakota, at $3,500.00 per month, effective 2025-07-01.
Do managed-care plans pay the same rate for S5125?
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
96158Positive behavioral interventions and support · 40 statesT1017Targeted case management, each 15 minutes · 37 statesT1016Case management, each 15 minutes · 36 statesT1001Nursing assessment / evaluation · 35 statesT1005Respite care services, up to 15 minutes · 35 statesS5170Home delivered meals, including preparation; per meal · 34 statesT2025Waiver services; not otherwise specified (nos) · 31 statesS5150Unskilled respite care, not hospice; per 15 minutes · 30 statesS5161Emergency response system; service fee, per month · 29 statesT2022Case management, per month · 28 statesG0101Respite care (daily) · 27 statesS5160Emergency response system; installation and testing · 27 states
Track S5125 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.