S5145 Medicaid reimbursement rates by state
Foster care, therapeutic, child; per diem. 11 state Medicaid programs publish a fee-for-service rate for S5145 at the unlicensed practitioner level. Rates run from $29.66 in Pennsylvania to $565.80 in California, with a median of $112.64.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 11
- Median rate
- $112.64units vary by state
- Highest
- $565.80California
- Medicare (non-facility)
- —not on the physician fee schedule
S5145 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 |
|---|---|---|---|---|---|---|
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal Specialty Mental Health Services (DHCS fee schedule for county Mental Health Plans) | $565.80since 2026-07-01 | 24 hour | — | Paid by the state, outside plans | — | Medi-Cal Behavioral Health Fee Schedules |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $386.11⚠ over 3× mediansince 2026-05-21 | day | — | Plans must pass increases through | — | MH Procedure CPT or HCPC Codes and Rates |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $364.88⚠ over 3× mediansince 2025-01-01 | day | — | Plans must pay at least this | — | Fee Schedule for Behavioral Health Provi |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Public Behavioral Health System (specialty mental health, SUD and ABA, paid fee-for-service through the Carelon ASO) | $243.99since 2024-07-01 | day | — | Paid by the state, outside plans | — | FY2025 PBHS Fee Schedule – PRP and Speci |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS behavioral health outpatient MCO capped fee schedule | $177.10since 2026-10-01 | — | — | Suggested schedule for plans | — | AHCCCS MCO Fee Schedule Final MCO Behavi |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $112.64since 2025-10-01 | day | — | Plans negotiate; applies out of network | — | NC Medicaid fee schedule 'Enhanced Menta |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $84.81since 2026-01-01 | day | — | Plans negotiate; applies out of network | — | Medical Foster Care Services Fee Schedul |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma Developmental Disabilities Services 1915(c) waivers (Community, In-Home Supports adults and children, Homeward Bound) | $61.78since 2024-10-01 | day | — | Paid by the state, outside plans | — | DDS Administrative Letter 24-02: Rate In |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $45.57since 2026-07-01 | day | — | Not classified | — | SCDHHS Rehabilitative Behavioral Health |
| TexasAgency provider · Texas Community Living Assistance and Support Services (CLASS) waiver | $30.48since 2024-09-01 | day | — | Paid by the state, outside plans | — | HHSC PFD CLASS payment rates (09-2024-cl |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $29.66since 2005-11-01 | day | — | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
Rates marked ⚠ are more than three times the median for the same unit; they are published as shown but often reflect an office (non-facility) fee or a different scope of service. 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 S5145?
It depends on the state. Of the 11 states with a published fee-for-service rate, the median is $112.64. California pays the most ($565.80 per 24 hour) and Pennsylvania the least ($29.66 per day).
Which state pays the highest Medicaid rate for S5145?
California, at $565.80 per 24 hour, effective 2026-07-01.
Do managed-care plans pay the same rate for S5145?
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.