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S5151 Medicaid reimbursement rates by state

Unskilled respite care, not hospice; per diem. 10 state Medicaid programs publish a fee-for-service rate for S5151 at the agency level. Rates run from $6.23 in Florida to $623.73 in Missouri, with a median of $147.31.

Data as of 2026-10-05. Every rate links to the official document it came from.

States publishing
10
Median rate
$147.31units vary by state
Highest
$623.73Missouri
Medicare (non-facility)
—not on the physician fee schedule

S5151 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.

StateMedicaid rateUnitPer hourManaged-care plans% of MedicareSource
MissouriAny qualified provider (rate does not vary by provider) · Missouri DD Community Support Waiver (DMH Division of DD, 1915(c))$623.73⚠ over 3× mediansince 2024-07-01day—Paid by the state, outside plans—MO HealthNet fee schedule: Community Sup
WisconsinAgency provider · Wisconsin Children's Long-Term Support (CLTS) Waiver (fee-for-service, statewide uniform rate schedule)$425.25since 2025-01-01day—Paid by the state, outside plans—CLTS Waiver Statewide Uniform Rate Sched
ColoradoAny qualified provider (rate does not vary by provider) · Colorado HCBS waiver: Supported Living Services (SLS)$310.72since 2023-07-01day—Paid by the state, outside plans—DD, SLS, CES (effective January 1, 2024)
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$184.24since 2026-10-01day—Plans expected to pay at least this—AHCCCS Final FFS Home and Community Base
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Alternative Care (AC, state-funded program for people 65+)$173.52since 2026-01-01day—Not classified—Long-Term Services and Supports Service
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Independent Care Waiver Program (adults with physical disabilities or brain injury)$121.09since 2024-07-01day—Paid by the state, outside plans—Part II Policies and Procedures: Indepen
IndianaAny qualified provider (rate does not vary by provider) · Indiana Money Follows the Person (PRTF transition track)$100.00since 2012-10-01day—Paid by the state, outside plans—IHCP Professional Fee Schedule (Last Upd
TexasAgency provider · Texas Home and Community-Based Services - Adult Mental Health (HCBS-AMH, 1915(i))$52.55since 2025-09-01day—Not classified—HHSC PFD HCBS-AMH payment rates (9-1-202
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Intellectual Disability and Related Disabilities (ID/RD) Waiver (SC.0237, DDSN-operated)$35.26since 2025-11-011/2 day = 2-3 hrs—Paid by the state, outside plans—SCDHHS HCBS Waivers Fee Schedule (Effect
FloridaAgency provider · Florida iBudget waiver for people with developmental disabilities (APD)$6.23since 2026-07-0115 min$24.92Paid by the state, outside plans—Florida Medicaid Developmental Disabilit

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 S5151?

It depends on the state. Of the 10 states with a published fee-for-service rate, the median is $147.31. Missouri pays the most ($623.73 per day) and Florida the least ($6.23 per 15 min).

Which state pays the highest Medicaid rate for S5151?

Missouri, at $623.73 per day, effective 2024-07-01.

Do managed-care plans pay the same rate for S5151?

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.

Related Other home & community services codes

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