S5102 Medicaid reimbursement rates by state
Day care services, adult; per diem. 24 state Medicaid programs publish a fee-for-service rate for S5102 at the agency level. Rates run from $10.70 in Virginia to $191.08 in Montana, with a median of $81.58.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 24
- Median rate
- $81.58units vary by state
- Highest
- $191.08Montana
- Medicare (non-facility)
- —not on the physician fee schedule
S5102 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 |
|---|---|---|---|---|---|---|
| MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service) | $191.08since 2025-07-01 | day | — | Not classified | — | Medicaid Mental Health Services for Adul |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare Home and Community Based Services for Adults with Brain Injury (MBM Section 18 waiver, fee-for-service) | $124.44since 2026-01-01 | day | — | Not classified | — | MaineCare Section 18 Brain Injury Waiver |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Community First Choice, Community Personal Assistance Services and Home and Community-Based Options Waiver / Increased Community Services | $116.59since 2024-07-01 | day | — | Paid by the state, outside plans | — | PT 04-25 Fiscal Year 2025 Rates for HCBO |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Home Care Waiver (ODM) | $106.26since 2026-04-17 | day | — | Plans negotiate; applies out of network | — | OAC 5160-46-06 (Register of Ohio final f |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Independent Care Waiver Program (adults with physical disabilities or brain injury) | $100.72since 2024-07-01 | day | — | Paid by the state, outside plans | — | Part II Policies and Procedures: Indepen |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $99.49since 2025-07-01 | day | — | Paid by the state, outside plans | — | Rates for Adult Day Health Services (eff |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $96.93since 2026-10-01 | day | — | Plans expected to pay at least this | — | AHCCCS Final FFS Home and Community Base |
| HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Med-QUEST HCBS fee-for-service rates (QI memos) | $87.21since 2025-01-01 | day | — | Plans negotiate; applies out of network | — | Med-QUEST memo QI-2501A: 2025 |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $87.00since 2025-01-01 | day | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington ALTSA adult day care and adult day health | $86.01since 2026-07-01 | day | — | Paid by the state, outside plans | — | DSHS ORM All HCS Rates |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $85.00since 2024-01-01 | day | — | Plans negotiate; applies out of network | — | 2026 Fee Schedule - Covered Procedures R |
| ColoradoAny qualified provider (rate does not vary by provider) · Colorado HCBS waiver for persons with a brain injury (BI) | $83.15since 2026-07-01 | day | — | Paid by the state, outside plans | — | EBD, CMHS, BI, CIH (effective July 1, 20 |
| 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)) | $80.00since 2025-11-01 | day | — | Paid by the state, outside plans | — | SCDHHS HCBS Waivers Fee Schedule (Effect |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $76.27since 2026-10-01 | day | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| WyomingAny qualified provider (rate does not vary by provider) · Wyoming DD waivers (Comprehensive and Supports, 1915(c)) | $61.87since 2023-10-01 | day | — | Not classified | — | Wyoming Medicaid Downloadable Fee Schedu |
| IowaAny qualified provider (rate does not vary by provider) · Iowa HCBS AIDS/HIV 1915(c) waiver | $52.51since 2025-08-01 | Full Day | — | Not classified | — | HCBS Habilitation and Waiver Upper Rate |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Adult Day Health Care Waiver (OAAS 1915(c) waiver) | $47.35since 2023-11-12 | day | — | Paid by the state, outside plans | — | Adult Day Health Care Waiver services pr |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina CAP consumer-directed option (CAP/CD) | $43.06since 2025-10-01 | day | — | Paid by the state, outside plans | — | NC Medicaid fee schedule 'CAP- Consumer |
| Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service) | $42.43since 2026-10-01 | day | — | Plans negotiate; applies out of network | — | RI Medicaid Interactive Fee For Service |
| NevadaAny qualified provider (rate does not vary by provider) · Nevada HCBS Waiver for the Frail Elderly (provider types 48, 57 and 59, fee-for-service) | $42.00since 2021-07-01 | day | — | Paid by the state, outside plans | — | Provider Type 48 Home and Community Base |
| UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan) | $39.18since 2011-07-01 | day | — | Plans negotiate; applies out of network | — | Utah Medicaid Coverage and Reimbursement |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania OBRA Waiver (adults with developmental physical disabilities) | $37.51since 2026-07-01 | 1/2 Day | — | Not classified | — | OLTL Home and Community Based Waiver Ser |
| FloridaAgency provider · Florida iBudget waiver for people with developmental disabilities (APD) | $22.71since 2026-07-01 | hour | $22.71 | Paid by the state, outside plans | — | Florida Medicaid Developmental Disabilit |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $10.70since 2026-07-01 | day | — | Plans must pay at least this | — | DMAS procedure fee file hcpcmedical.csv |
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 S5102?
It depends on the state. Of the 24 states with a published fee-for-service rate, the median is $81.58. Montana pays the most ($191.08 per day) and Virginia the least ($10.70 per day).
Which state pays the highest Medicaid rate for S5102?
Montana, at $191.08 per day, effective 2025-07-01.
Do managed-care plans pay the same rate for S5102?
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.
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Track S5102 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.