S5116 Medicaid reimbursement rates by state
Home care training, non-family; per session. 6 state Medicaid programs publish a fee-for-service rate for S5116 at the family caregiver level. Rates run from $48.15 in Illinois to $5,000.00 in Indiana, with a median of $79.21.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 6
- Median rate
- $79.21units vary by state
- Highest
- $5,000.00Indiana
- Medicare (non-facility)
- —not on the physician fee schedule
S5116 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 |
| MinnesotaAgency provider · Minnesota Community First Services and Supports (CFSS) | $1,330.37since 2026-04-01 | Per Authorization Year | — | Paid by the state, outside plans | — | Long-Term Services and Supports Service |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia developmental disability waivers (Building Independence, Family and Individual Supports, Community Living) | $80.91since 2024-07-01 | hour | $80.91 | Paid by the state, outside plans | — | DMAS Developmental Disabilities Waiver S |
| 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 |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $50.00since 2023-01-01 | — | — | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| IllinoisLicensed practical / vocational nurse (LPN / LVN) · Illinois Medically Fragile, Technology Dependent waiver (IL.0278) and EPSDT in-home nursing, operated by UIC-DSCC | $48.15since 2025-01-01 | Client Hour | — | Not classified | — | Medically Fragile Technology Dependent ( |
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 S5116?
It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $79.21. Indiana pays the most ($5,000.00 per unit) and Illinois the least ($48.15 per Client Hour).
Which state pays the highest Medicaid rate for S5116?
Indiana, at $5,000.00 per unit, effective 2020-07-16.
Do managed-care plans pay the same rate for S5116?
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.