S5136 Medicaid reimbursement rates by state
Companion care, adult (e.g., iadl/adl); per diem. 13 state Medicaid programs publish a fee-for-service rate for S5136 at the aide level. Rates run from $13.88 in Virginia to $303.75 in Washington, with a median of $112.50.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 13
- Median rate
- $112.50units vary by state
- Highest
- $303.75Washington
- Medicare (non-facility)
- —not on the physician fee schedule
S5136 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 DSHS HCBS payment rate disclosure (42 CFR 447.203) | $303.75since 2025-07-01 | day | — | Paid by the state, outside plans | — | DSHS Rate Disclosure Publication (rates |
| MissouriAide or attendant (HHA, CNA, PCA, home care aide) · Missouri DD Comprehensive Waiver (DMH Division of DD, 1915(c)) | $232.28since 2024-07-01 | day | — | Paid by the state, outside plans | — | MO HealthNet fee schedule: Comprehensive |
| ArizonaAide or attendant (HHA, CNA, PCA, home care aide) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $182.03since 2026-10-01 | day | — | Plans expected to pay at least this | — | AHCCCS Final FFS Home and Community Base |
| MississippiAide or attendant (HHA, CNA, PCA, home care aide) · Mississippi Medicaid (fee-for-service) | $136.50since 2016-07-01 | day | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, Septembe |
| UtahAide or attendant (HHA, CNA, PCA, home care aide) · Utah Medicaid (fee-for-service, Traditional plan) | $119.41since 2018-07-01 | day | — | Plans negotiate; applies out of network | — | Utah Medicaid Coverage and Reimbursement |
| IowaAny qualified provider (rate does not vary by provider) · Iowa HCBS Intellectual Disability (ID) 1915(c) waiver | $118.96since 2025-08-01 | day | — | Plans must pay at least this | — | HCBS Intellectual Disability (ID) Waiver |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Acquired Brain Injury (ABI, acute) 1915(c) waiver | $112.50since 2025-01-01 | day | — | Paid by the state, outside plans | — | DMS Home and Community Based Services Wa |
| 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) | $94.90since 2026-10-01 | day | — | Paid by the state, outside plans | — | New Opportunities Waiver rate and proced |
| TexasAgency provider · Texas Home and Community-Based Services - Adult Mental Health (HCBS-AMH, 1915(i)) | $82.40since 2025-09-01 | day | — | Not classified | — | HHSC PFD HCBS-AMH payment rates (9-1-202 |
| OhioPaid family caregiver / legally responsible individual · Ohio Home Care Waiver (ODM) | $51.34since 2026-04-17 | Per half day | — | Plans negotiate; applies out of network | — | OAC 5160-46-06 (Register of Ohio final f |
| Rhode IslandAide or attendant (HHA, CNA, PCA, home care aide) · Rhode Island Medicaid long-term services and supports, home and community based (1115 waiver, fee-for-service) | $41.25since 2026-10-01 | day | — | Paid by the state, outside plans | — | RI Medicaid Interactive Fee For Service |
| ConnecticutAide or attendant (HHA, CNA, PCA, home care aide) · Connecticut DDS HCBS waivers - self-directed (self-hire) rates | $15.69since 2024-05-01 | hour | $15.69 | Not classified | — | DDS FY25 Vendor Self Hire Rates (Self-Hi |
| 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 |
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 S5136?
It depends on the state. Of the 13 states with a published fee-for-service rate, the median is $112.50. Washington pays the most ($303.75 per day) and Virginia the least ($13.88 per hour).
Which state pays the highest Medicaid rate for S5136?
Washington, at $303.75 per day, effective 2025-07-01.
Do managed-care plans pay the same rate for S5136?
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.