S9125 Medicaid reimbursement rates by state
Respite care, in the home, per diem. 13 state Medicaid programs publish a fee-for-service rate for S9125 at the lpn level. Rates run from $34.04 in New Hampshire to $938.09 in Minnesota, with a median of $188.89.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 13
- Median rate
- $188.89units vary by state
- Highest
- $938.09Minnesota
- Medicare (non-facility)
- —not on the physician fee schedule
S9125 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 |
|---|---|---|---|---|---|---|
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $938.09⚠ over 3× mediansince 2015-07-01 | day | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Community Long Term Care waivers (Community Choices, HIV/AIDS, Mechanical Ventilator Dependent; 1915(c)) | $500.00since 2025-11-01 | day | — | Paid by the state, outside plans | — | SCDHHS HCBS Waivers Fee Schedule (Effect |
| District of ColumbiaAny qualified provider (rate does not vary by provider) · DC Medicaid (DHCF) fee-for-service | $496.96since 2024-01-01 | day | — | Not classified | — | REFRP00178CSV - Medical Fee Schedule Rep |
| Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island developmental disabilities services (BHDDH, paid fee-for-service under the 1115 waiver) | $449.29since 2026-10-01 | day | — | Paid by the state, outside plans | — | RI Medicaid Interactive Fee For Service |
| VermontAny qualified provider (rate does not vary by provider) · Vermont Brain Injury Program (TBI; DAIL ASD), Rehab/Long Term (U8) and Mental Health Funded (HI/UD) | $272.18since 2025-07-13 | 1 day | — | Not classified | — | DAIL Adult Services Division - Billing C |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $250.00since 2025-01-01 | day | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| FloridaLicensed practical / vocational nurse (LPN / LVN) · Florida iBudget waiver for people with developmental disabilities (APD) | $188.89since 2026-07-01 | day | — | Paid by the state, outside plans | — | Florida Medicaid Developmental Disabilit |
| ColoradoAide or attendant (HHA, CNA, PCA, home care aide) · Colorado HCBS waiver for children with complex health needs (CwCHN) | $152.89since 2026-07-01 | day | — | Paid by the state, outside plans | — | CwCHN, CHRP (effective July 1, 2026) |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Children's Long-Term Support (CLTS) Waiver (fee-for-service, statewide uniform rate schedule) | $102.82since 2025-01-01 | day | — | Paid by the state, outside plans | — | CLTS Waiver Statewide Uniform Rate Sched |
| VirginiaLicensed practical / vocational nurse (LPN / LVN) · Virginia Medicaid (fee-for-service, DMAS) | $55.59since 2025-07-01 | day | — | Plans must pay at least this | — | DMAS procedure fee file hcpcmedical.csv |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Adults with Developmental Disabilities 1915(c) Waiver (ID.0076) | $51.25since 2026-07-01 | day | — | Paid by the state, outside plans | — | Adult Developmental Disabilities Waiver |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma Developmental Disabilities Services 1915(c) waivers (Community, In-Home Supports adults and children, Homeward Bound) | $39.19since 2024-10-01 | day | — | Paid by the state, outside plans | — | DDS Administrative Letter 24-02: Rate In |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire home and community-based care for high-risk children with severe emotional disturbance | $34.04since 2023-07-01 | day | — | Paid by the state, outside plans | — | 2023 Children's Mental Health HCBC Medic |
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 S9125?
It depends on the state. Of the 13 states with a published fee-for-service rate, the median is $188.89. Minnesota pays the most ($938.09 per day) and New Hampshire the least ($34.04 per day).
Which state pays the highest Medicaid rate for S9125?
Minnesota, at $938.09 per day, effective 2015-07-01.
Do managed-care plans pay the same rate for S9125?
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.