Home care Medicaid rates in Utah sit in a category of their own. Utah Medicaid pays $21.21 per 15 minutes for personal care on S5125, or $84.84 an hour. That is the highest rate of 27 ranked states and 178.0% above the $30.52 national median. The next-highest state, Oregon, pays $42.24.
For a personal care or attendant agency, that is the single most important fact about Utah. Everything else in the state's home care schedule is close to typical; the attendant rate is not. Every figure below is compiled from official Utah Medicaid publications and linked to its source document.
The $84.84 hourly rate took effect on 2026-07-01. It appears on the Aging Waiver Codes and Rates schedule, effective July 1, 2026, which records a 24.62% change. Utah runs personal care through several waivers, including the Utah Aging waiver for older adults, the New Choices waiver, the Physical Disabilities waiver and the Community Transitions waiver, alongside fee-for-service Utah Medicaid.
To put the rate in context, the top of the national ranking looks like this:
| State | Code | Rate per hour |
|---|---|---|
| Utah | S5125 | $84.84 |
| Oregon | OR545 | $42.24 |
| Iowa | T1019 | $42.00 |
| Delaware | T1019 | $39.35 |
| Missouri | T1019 | $39.00 |
| National median (30 states) | $30.52 |
Every other state's hourly rate falls between $42.24 and the $18.28 paid by Texas. Utah pays more than double the second-highest state.
Utah publishes most in-home services on national HCPCS codes in 15-minute units. The $84.84 hourly figure is four units of $21.21 on S5125, and the companion figure is four units of $7.27 on S5135.
A few Utah lines use different units or state codes:
- Daily respite on S5151 is paid per day.
- Hourly respite uses a state code, RL1, published per unit.
- Self-direction financial management on T2040 is published per 15 minutes rather than per month, as most states do.
For billing teams, the main point is that the waiver on the authorization must match the rate row on the claim. Utah runs personal care through several waivers, and the headline $84.84 rate belongs to the Aging waiver schedule.
The median wage for home health and personal care aides in Utah was $17.25 an hour in May 2025, almost exactly the $17.21 US median. Registered nurses earned $40.67, below the $46.90 national median.
Because the wage is ordinary and the rate is not, Utah's economics are unlike any other state's:
- Personal care: the aide wage is 28.9% of the $84.84 rate, leaving $60.32 an hour after a loaded wage.
- Companion care: the aide wage is 84.3% of the $29.08 rate, leaving $4.56 an hour.
The contrast is the story. The same aide, at the same wage, produces a margin of $60.32 an hour on personal care and $4.56 on companion care. An agency in Utah has every reason to build around authorized personal care hours and to treat companion services as a supporting line.
A rate this far above the rest of the country invites the question of what it is meant to fund. The rate is published for an agency provider, and an agency's hourly cost is more than the aide's wage. It includes:
- Payroll costs on top of the wage: taxes, workers' compensation and benefits. The margin figures above already account for these.
- Supervision and training, including any nurse oversight the waiver requires.
- Travel time and mileage between clients, which is unpaid time for the agency.
- Scheduling, billing and compliance staff and systems.
- Missed visits and cancellations, which leave an aide paid but no hour billed.
Even after those costs, Utah's personal care rate leaves more room than any other state. That gives agencies the ability to pay above the median wage, staff harder-to-serve clients and absorb rural travel. It also means the rate is likely to draw scrutiny, and the personal care reporting bulletins issued alongside it suggest the state expects careful documentation in return.
Outside personal care, Utah's rates are close to the middle of the national range.
Companion care. Utah pays $7.27 per 15 minutes on S5135, or $29.08 an hour, effective since 2019-07-01. That ranks 7th of 20 states and is 12.0% above the $25.96 median. Vermont leads at $51.92.
Daily respite. Utah pays $311.30 a day on S5151, effective since 2022-01-01. That ranks 12th of 34 states and is 28.5% above the $242.21 median.
Other services. Utah also publishes an hourly respite code (RL1, $7.17 per unit), adult day care on S5100 at $7.96 per 15 minutes ($31.84 an hour, effective since 2004-07-01), and self-direction financial management on T2040 at $95.24 per 15 minutes. These units differ from how other states publish the same services, so they are not ranked here.
Several of these rates have been unchanged for years. The companion rate dates from 2019 and the adult day rate from 2004, while the personal care rate was reset in 2026.
In Utah, personal care and home and community-based services are paid directly by the state, outside managed care. Home health, by contrast, is a line where plans negotiate and the published rate applies out of network.
For a personal care agency, the practical result is simple: the published rate is the rate. There is no plan contract to negotiate for these services, and no plan can pay below the schedule. Utah has 27 plans in our data, but they do not set personal care pay. The Utah managed care page lists the plans and the rule for each service line.
The split matters for agencies that offer both personal care and skilled home health. The personal care side bills one state schedule with no negotiation, while the home health side requires plan contracts, and an agency without them is paid the published rate only as an out-of-network provider. Keeping the two lines on separate billing workflows avoids sending a claim to the wrong payer.
Utah attaches no prior authorization rules to the home care codes in our data, including S5125, S5130, S5135, S5100 and S5102. S5150 carries a daily limit. Authorization is set at the waiver level rather than on the code.
Recent Medicaid Information Bulletins (MIB) relevant to this line include:
- Aging Waiver Codes and Rates schedule, effective July 1, 2026, with a 24.62% change. This is the source of the current S5125 rate.
- MIB July 2026 26-82 Rural Enhancement Modifier Clarification, effective 2026-07-01.
- MIB January 2026 26-17 Personal Care Services Reporting Changes, effective 2026-01-01.
- MIB November 2025 25-88 Personal Care Services Policy Update, effective 2026-01-01.
Two bulletins on personal care in the same cycle as a large rate change suggest that billing and reporting rules moved alongside the rate. Agencies should read them together.
The rural enhancement modifier
The July 2026 clarification of the Rural Enhancement Modifier matters for agencies serving clients in rural parts of the state. A rural modifier changes the rate row a claim is priced on, so agencies with rural clients should confirm when it applies and add it to the right claims from the effective date.
Utah's home care rates are spread across fee-for-service Utah Medicaid and a long list of 1915(c) waivers:
- Aging waiver for individuals age 65 or older, the source of the headline S5125 rate.
- New Choices waiver and Community Transitions waiver, which support people moving out of or avoiding institutional care.
- Physical Disabilities waiver and Acquired Brain Injury waiver.
- Community Supports and Limited Supports waivers for intellectual disabilities and related conditions.
- Technology Dependent and Medically Complex Children's waivers.
Each waiver publishes its own codes and rates. An agency serving several should forecast revenue by waiver, because the same code can be priced very differently from one waiver to the next.
Utah is first for personal care and above the median for companion care and daily respite. No ranked service in this line puts Utah near the bottom. At the other end of the country, Texas pays $18.28 an hour for personal care, Louisiana $19.08 and Pennsylvania $19.48.
Within the Mountain region, Wyoming home care rates and Colorado home care rates are the closest comparisons for agencies working across state lines. For the national view, see home care Medicaid rates by state.
Budgeting. Forecast by waiver and code. A caseload of Aging waiver personal care behaves very differently from one built on companion care or other waivers, even at the same hours.
Growth decisions. The personal care margin makes authorized personal care hours the line to build around. Companion care, at $4.56 an hour, is a supporting service.
Compliance. Read the 2026 personal care policy and reporting bulletins before scaling. A rate this high rewards accurate documentation and punishes errors.
Wage strategy. Utah's margin leaves room to pay above the state median and compete for aides, which is the main constraint on growth when the rate is not.
Each rate is compiled from official Utah Medicaid publications, including the Aging Waiver Codes and Rates schedule and the Utah Medicaid Coverage and Reimbursement Lookup, and links to its source document. Utah's full dataset holds all 44,888 current Utah Medicaid rates, with history back to 1985; the Utah Medicaid rates hub covers every other service line. Our methodology explains how per-hour conversions and rankings are built.