S5111 Medicaid reimbursement rates by state
Home care training, family; per session. 5 state Medicaid programs publish a fee-for-service rate for S5111 at the family caregiver level. Rates run from $12.00 in Vermont to $5,000.00 in Indiana, with a median of $77.50.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 5
- Median rate
- $77.50units vary by state
- Highest
- $5,000.00Indiana
- Medicare (non-facility)
- —not on the physician fee schedule
S5111 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 |
|---|---|---|---|---|---|---|
| IndianaPaid family caregiver / legally responsible individual · Indiana Community Integration and Habilitation (CIH) Waiver for people with IDD | $5,000.00since 2020-07-16 | unit | — | Paid by the state, outside plans | — | IHCP Professional Fee Schedule (Last Upd |
| HawaiiAny qualified provider (rate does not vary by provider) · Hawaii DOH DDD Medicaid I/DD waiver (1915(c) HI.0013) | $175.80since 2025-07-01 | hour | $175.80 | Paid by the state, outside plans | — | DOH DDD I/DD Waiver Schedule of Rates (m |
| LouisianaAgency provider · Louisiana Community Choices Waiver (OAAS 1915(c) waiver for older adults and adults with disabilities) | $77.50since 2024-01-01 | visit | — | Paid by the state, outside plans | — | Community Choices Waiver services proced |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $35.77since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| VermontAgency provider · Vermont Medicaid (fee-for-service, DVHA) | $12.00since 2010-01-01 | — | — | Not classified | — | Vermont Medicaid Fee Schedule - HCPCS (i |
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 S5111?
It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $77.50. Indiana pays the most ($5,000.00 per unit) and Vermont the least ($12.00).
Which state pays the highest Medicaid rate for S5111?
Indiana, at $5,000.00 per unit, effective 2020-07-16.
Do managed-care plans pay the same rate for S5111?
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.