S5135 Medicaid reimbursement rates by state
Companion care, adult (e.g., iadl/adl); per 15 minutes. 6 state Medicaid programs publish a fee-for-service rate for S5135 at the aide level. Rates run from $2.17 in Minnesota to $20.23 in Virginia, with a median of $5.06.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 6
- Median rate
- $5.06units vary by state
- Highest
- $20.23Virginia
- Medicare (non-facility)
- —not on the physician fee schedule
S5135 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 |
|---|---|---|---|---|---|---|
| VirginiaAide or attendant (HHA, CNA, PCA, home care aide) · Virginia developmental disability waivers (Building Independence, Family and Individual Supports, Community Living) | $20.23since 2025-07-01 | hour | $20.23 | Paid by the state, outside plans | — | DMAS Developmental Disabilities Waiver S |
| North CarolinaAide or attendant (HHA, CNA, PCA, home care aide) · North Carolina CAP consumer-directed option (CAP/CD) | $6.42since 2026-08-01 | 15 min | $25.68 | Paid by the state, outside plans | — | NC Medicaid fee schedule 'CAP- Consumer |
| 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 |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Home Care Waiver (ODM) | $3.93since 2026-04-17 | Per fifteen-minute unit | — | Plans negotiate; applies out of network | — | OAC 5160-46-06 (Register of Ohio final f |
| FloridaAny qualified provider (rate does not vary by provider) · Florida iBudget waiver for people with developmental disabilities (APD) | $3.33since 2026-07-01 | 15 min | $13.32 | Paid by the state, outside plans | — | Florida Medicaid Developmental Disabilit |
| MinnesotaAide or attendant (HHA, CNA, PCA, home care aide) · Minnesota Brain Injury (BI) waiver | $2.17since 2026-01-01 | 15 min | $8.68 | Paid by the state, outside plans | — | Long-Term Services and Supports 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 S5135?
It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $5.06. Virginia pays the most ($20.23 per hour) and Minnesota the least ($2.17 per 15 min).
Which state pays the highest Medicaid rate for S5135?
Virginia, at $20.23 per hour ($20.23 per hour), effective 2025-07-01.
Do managed-care plans pay the same rate for S5135?
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.