Home care Medicaid rates in Nevada are built around a single hourly figure. Respite on S5150 and companion care on S5135 both pay $6.25 per 15 minutes, or $25.00 an hour. For respite that ranks 21st of 38 states, 1.2% below the $25.30 national median; for companion care it ranks 11th of 20, 3.7% below the $25.96 median.
In other words, Nevada pays close to the middle of the country for hourly home care, but below the middle on daily services and adult day. All rates are compiled from official state Medicaid publications and linked to their source documents; the complete schedule is on the Nevada Medicaid rates hub.
| Service | Code | Nevada rate | Rank | vs national median |
|---|---|---|---|---|
| Companion care | S5135 | $25.00 / hour | 11 of 20 | -3.7% |
| Respite (hourly) | S5150 | $25.00 / hour | 21 of 38 | -1.2% |
| Respite (daily) | S5151 | $150.00 / day | 26 of 34 | -38.1% |
| Adult day | S5102 | $42.00 / day | 11 of 12 | -38.8% |
The hourly and daily rates have been in effect since January 1, 2024, the effective date of Nevada's last published personal care and Frail Elderly waiver rate updates. The adult day rate dates from July 1, 2021.
Nevada does not publish an agency personal care rate that fits our national hourly comparison. For context, the national median for personal care is $30.52 an hour, from Utah's $84.84 at the top to Texas's $18.28 at the bottom.
Nevada Medicaid publishes its rates by provider type, a numbered category that identifies who is billing. Home care rates sit in several of them:
- HCBS Waiver for the Frail Elderly, billed by provider types 48, 57 and 59.
- HCBS Waiver for Persons with Physical Disabilities, billed by provider type 58.
- 1915(i) HCBS State Plan Option for Adult Day Health Care and Habilitation, billed by provider types 39 and 55.
- HCBS Waiver for Structured Family Caregiving, billed by provider type 95.
- HCBS Waiver for Individuals with Intellectual and Developmental Disabilities, billed by provider type 38.
The state also funds non-Medicaid programs through its Aging and Disability Services Division, including the Community Options Program for the Elderly and a Personal Assistance Services program.
For an agency, the provider type is more than a label. It decides which services can be billed and which schedule prices them. An agency serving both frail elderly and physically disabled clients may need more than one enrollment.
At $25.00 an hour, Nevada's two hourly services sit just under their national medians, so a Nevada agency is paid roughly like a typical state.
The spread around Nevada is wide. For hourly respite, Virginia pays $74.04, New York $59.32 and South Dakota $43.24, while Nebraska ($14.95), Idaho ($14.04) and Indiana ($14.00) are lowest. For companion care, Vermont pays $51.92, South Dakota $43.24 and Montana $37.56, while Nebraska ($11.33), Iowa ($8.48) and Arkansas ($6.72) pay least.
Nevada's companion rank of 11 of 20 looks better than its respite rank of 21 of 38 partly because fewer states publish a comparable companion rate, and the bottom of that list pays very little.
Same rate, different services
Paying respite and companion care at an identical $25.00 an hour is unusual. In most states companion care is priced below respite, because it involves supervision and social support rather than relief for a family caregiver. Nevada's flat rate means an agency can staff both services with the same pool of aides at the same pay without one line subsidizing the other. It also means neither line offers a premium: there is no higher-paying hourly service to balance the thin margin on these two.
Daily respite pays $150.00, 38.1% below the $242.21 national median and 26th of 34 states. Minnesota ($938.09), Missouri ($623.73) and Pennsylvania ($548.81) lead; New Mexico ($73.09), Idaho ($51.25) and New Hampshire ($34.04) trail.
Adult day services are where Nevada is furthest down the table. At $42.00 a day, Nevada is 11th of 12 ranked states, ahead only of Virginia ($10.70) and just behind Rhode Island ($42.43). Maine pays $124.44, and New Jersey $87.00. For an adult day operator, Nevada's rate is near the bottom of every state that publishes a comparable daily rate.
The median wage for home health and personal care aides in Nevada was $16.19 an hour in May 2025, below the $17.21 national median. Registered nurses earned a median $49.84, above the $46.90 national figure.
On both respite and companion care, the aide wage takes 92.0% of the $25.00 rate, and the margin after a loaded wage is $1.99 an hour. That leaves very little for scheduling, travel, training and administration. A Nevada agency paying above the median aide wage to recruit staff would quickly turn those services unprofitable at the published rate.
Nevada's coverage rules for home care codes are light. Respite on S5150 carries 1 prior authorization rule and is limited to the hours in the plan of care. Code S5199 carries no prior authorization rules. Billing staff should match respite claims to the hours authorized in each member's plan of care, since hours beyond the plan are not payable regardless of need on the day.
Nevada Medicaid runs managed care through the Mandatory Health Maintenance Program, with 9 plans and products in our data, including Anthem Blue Cross and Blue Shield Healthcare Solutions, CareSource Nevada, Health Plan of Nevada, Molina Healthcare of Nevada and SilverSummit Health Plan. Home care, however, sits outside it. Nevada pays personal care, home and community-based services, private duty nursing and intellectual and developmental disability services directly, outside managed care. For home health, plans negotiate and the published rate applies out of network.
The practical result is that a Nevada home care agency deals with one payer and one schedule. Rates change only when the state changes them, and they change for every provider of the same type at once. Managed-care rules for every service line are on the Nevada managed care page.
- Public Notice for 1915i PCS for Kids, published September 30, 2026, with a proposed effective date of January 1, 2027.
- CMS approved NV-24-0024, effective March 1, 2025.
- Web Announcement 3270: Rate Increases for Personal Care Services (PCS) and PCS-Like Services, effective January 1, 2024, followed by Web Announcement 3319, which reprocessed PCS claims to pay the updated rates.
- Web Announcement 3288: Rate Updates Implemented for Home and Community Based Waiver for the Frail Elderly Services, effective January 1, 2024, and Web Announcement 3300, which reprocessed waiver claims at the updated rates.
The hourly rates in our data still carry the January 1, 2024 effective date.
What the claim reprocessing tells providers
The January 2024 increases were announced after their effective date, and the state later reprocessed claims that had already paid at the old rates. That is a common pattern with retroactive increases. Agencies should keep claim-level records that make it easy to confirm each reprocessed claim paid at the new rate, since underpayments on reprocessing are easy to miss.
The most significant pending change is the proposed 1915(i) PCS for Kids program. The public notice was published September 30, 2026, with a proposed effective date of January 1, 2027, and the matching state plan amendment, SPA 26-0021, is pending at CMS.
A 1915(i) program provides home and community-based services under the state plan, without the slot limits of a waiver. For agencies, a children's personal care benefit could open a new referral stream, with its own eligibility rules, documentation and rate schedule. Agencies interested in serving children should read the notice, check the staff qualifications it sets and be ready to enroll once CMS approves. Separately, Nevada has opened public comment on a Structured Family Caregiving Waiver amendment, which affects paid family caregiving.
Nevada pays close to the national middle for hourly home care but well below it for daily services. Utah leads the country on personal care, Montana pays $37.56 for companion care, and Idaho is among the lowest for both hourly and daily respite. Texas sits at the bottom of the personal care ranking.
Price the hourly lines carefully
With respite and companion care at a $1.99 margin, an agency's profit depends on travel time and scheduling. Grouping visits geographically, so that aides spend more of the day with clients and less on the road, protects that margin. Short visits are the hardest to make pay, because travel time between them is unpaid.
Be cautious with daily and adult day services
At $150.00 a day for respite and $42.00 for adult day, these lines are hard to staff above the minimum. Model them carefully before expanding.
Track the pending changes
PCS for Kids and the Structured Family Caregiving amendment could both change the market in 2027. Build them into next year's plan as scenarios.
Rates on this page are compiled from official state Medicaid publications, including Nevada Medicaid provider-type reimbursement schedules and the web announcements and public notices named above. Each rate links to its source document on the Nevada Medicaid rates hub, which covers all 79,042 current Nevada Medicaid rates. Wage figures are state and US medians for May 2025.
See the national home care Medicaid rate comparison, our methodology, and access options on the pricing page.