S5126 Medicaid reimbursement rates by state
Attendant care services; per diem. 9 state Medicaid programs publish a fee-for-service rate for S5126 at the aide level. Rates run from $8.68 in Montana to $194.81 in Washington, with a median of $103.00.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 9
- Median rate
- $103.00units vary by state
- Highest
- $194.81Washington
- Medicare (non-facility)
- —not on the physician fee schedule
S5126 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 |
|---|---|---|---|---|---|---|
| WashingtonAide or attendant (HHA, CNA, PCA, home care aide) · Washington Apple Health (Medicaid) fee-for-service | $194.81since 2024-07-01 | day | — | Plans must pay at least this | — | HCA Community behavioral health support |
| OklahomaAgency provider · Oklahoma Developmental Disabilities Services 1915(c) waivers (Community, In-Home Supports adults and children, Homeward Bound) | $179.47since 2024-10-01 | day | — | Paid by the state, outside plans | — | DDS Administrative Letter 24-02: Rate In |
| MissouriAide or attendant (HHA, CNA, PCA, home care aide) · Missouri Structured Family Caregiving Waiver (DHSS, 1915(c)) | $110.33since 2026-07-01 | day | — | Paid by the state, outside plans | — | MO HealthNet fee schedule: Structured Fa |
| UtahAide or attendant (HHA, CNA, PCA, home care aide) · Utah Medicaid (fee-for-service, Traditional plan) | $104.57since 2015-07-01 | day | — | Plans negotiate; applies out of network | — | Utah Medicaid Coverage and Reimbursement |
| NevadaAide or attendant (HHA, CNA, PCA, home care aide) · Nevada HCBS Waiver for the Frail Elderly (provider types 48, 57 and 59, fee-for-service) | $103.00since 2024-01-01 | day | — | Paid by the state, outside plans | — | Provider Type 57 Waiver for Elderly in A |
| VermontAide or attendant (HHA, CNA, PCA, home care aide) · Vermont Medicaid (fee-for-service, DVHA) | $85.00since 2021-02-01 | day | — | Not classified | — | Vermont Medicaid Fee Schedule - HCPCS (i |
| 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) | $38.88since 2026-03-13 | day | — | Paid by the state, outside plans | — | New Opportunities Waiver rate and proced |
| VirginiaAide or attendant (HHA, CNA, PCA, home care aide) · Virginia developmental disability waivers (Building Independence, Family and Individual Supports, Community Living) | $13.88since 2025-07-01 | hour | $13.88 | Paid by the state, outside plans | — | DMAS Developmental Disabilities Waiver S |
| MontanaAgency provider · Montana Community First Choice and Personal Care Services (1915(k) and state plan, fee-for-service) | $8.68since 2026-07-01 | day | — | Not classified | — | Montana Healthcare Programs fee schedule |
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 S5126?
It depends on the state. Of the 9 states with a published fee-for-service rate, the median is $103.00. Washington pays the most ($194.81 per day) and Montana the least ($8.68 per day).
Which state pays the highest Medicaid rate for S5126?
Washington, at $194.81 per day, effective 2024-07-01.
Do managed-care plans pay the same rate for S5126?
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.