S5160 Medicaid reimbursement rates by state
Emergency response system; installation and testing. 27 state Medicaid programs publish a fee-for-service rate for S5160 at the agency level. Rates run from $1.06 in New Mexico to $500.00 in Minnesota, with a median of $53.96.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 27
- Median rate
- $53.96units vary by state
- Highest
- $500.00Minnesota
- Medicare (non-facility)
- —not on the physician fee schedule
S5160 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 |
|---|---|---|---|---|---|---|
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Alternative Care (AC, state-funded program for people 65+) | $500.00since 2026-01-01 | Each Time | — | Not classified | — | Long-Term Services and Supports Service |
| FloridaAny qualified provider (rate does not vary by provider) · Florida iBudget waiver for people with developmental disabilities (APD) | $276.63since 2026-07-01 | unit | — | Paid by the state, outside plans | — | Florida Medicaid Developmental Disabilit |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Independent Care Waiver Program (adults with physical disabilities or brain injury) | $121.11since 2024-07-01 | per resident | — | Paid by the state, outside plans | — | Part II Policies and Procedures: Indepen |
| MontanaAny qualified provider (rate does not vary by provider) · Montana Big Sky Waiver for elderly and physically disabled adults (1915(c), fee-for-service) | $115.17since 2025-07-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| North DakotaAgency provider · North Dakota Adults and Aging HCBS Qualified Service Provider (QSP) rates (lines naming no single funding program) | $78.03since 2026-07-01 | — | — | Not classified | — | QSP Rates and Rural Differential Rate (C |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $78.00since 2025-01-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| HawaiiAny qualified provider (rate does not vary by provider) · Hawaii DOH DDD Medicaid I/DD waiver (1915(c) HI.0013) | $65.00since 2025-07-01 | Installa tion | — | Paid by the state, outside plans | — | DOH DDD I/DD Waiver Schedule of Rates (m |
| IdahoAgency provider · Idaho Aged and Disabled 1915(c) Waiver (ID.1076) | $64.44since 2025-09-01 | One-time | — | Not classified | — | Personal Assistance Agency Fee Schedule |
| WyomingAny qualified provider (rate does not vary by provider) · Wyoming Community Choices Waiver (1915(c), elderly and physically disabled) | $63.09since 2023-04-01 | one time | — | Not classified | — | CCW Waiver Fee Schedule - Effective Apri |
| IowaAny qualified provider (rate does not vary by provider) · Iowa HCBS Brain Injury (BI) 1915(c) waiver | $58.48since 2025-08-01 | Initial One-Time | — | Not classified | — | HCBS Habilitation and Waiver Upper Rate |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $58.41since 2011-07-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file hcpcmedical.csv |
| UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan) | $56.29since 2006-02-01 | — | — | Plans negotiate; applies out of network | — | Utah Medicaid Coverage and Reimbursement |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Health & Wellness Waiver (adults with disabilities under 60; formerly A&D) | $54.41since 2008-07-01 | one time | — | Paid by the state, outside plans | — | IHCP Professional Fee Schedule (Last Upd |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare Home and Community Benefits for the Elderly and Adults with Disabilities (MBM Section 19 waiver, fee-for-service) | $53.96since 2026-01-01 | 1 Unit - Customary Charge, not to exceed | — | Not classified | — | MaineCare Section 19 Elderly and Adults |
| Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island developmental disabilities services (BHDDH, paid fee-for-service under the 1115 waiver) | $50.00since 2011-07-01 | — | — | Paid by the state, outside plans | — | RI Medicaid Interactive Fee For Service |
| District of ColumbiaAny qualified provider (rate does not vary by provider) · DC Medicaid (DHCF) fee-for-service | $45.00since 2020-10-01 | — | — | Not classified | — | REFRP00178CSV - Medical Fee Schedule Rep |
| 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) | $45.00since 2021-07-01 | — | — | Paid by the state, outside plans | — | Provider Type 48 Home and Community Base |
| AlaskaAny qualified provider (rate does not vary by provider) · Alaska 1915(c) home and community-based waivers (Senior and Disabilities Services) | $45.00since 2018-07-01 | — | — | Not classified | — | Specialized Medical Equipment Fee Schedu |
| AlabamaAny qualified provider (rate does not vary by provider) · Alabama Community Waiver Program (1115 demonstration with 1915(c)/1915(i) services; ADMH-DDD) | $40.00since 2020-12-17 | Plan | — | Not classified | — | ADMH Community Waiver Program Rate Sheet |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Persons with Brain Injury waiver (DHS-DRS Home Services Program, IL.0329) | $40.00since 2026-07-01 | SVC | — | Plans must pay at least this | — | HSP Rates and Fees (Medicaid Waiver Serv |
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services) | $38.76since 2026-07-01 | — | — | Not classified | — | South Dakota Medicaid Physician fee sche |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $38.53since 2026-03-01 | — | — | Plans negotiate; applies out of network | — | Rates for Durable Medical Equipment, Oxy |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Home Care Waiver (ODM) | $32.95since 2026-04-17 | Per installation and testing | — | Plans negotiate; applies out of network | — | OAC 5160-46-06 (Register of Ohio final f |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Residential Options Waiver (ROW, OCDD/OIDD 1915(c) waiver) | $30.00since 2025-11-18 | One Time | — | Paid by the state, outside plans | — | Residential Options Waiver rate and proc |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Intellectual Disability and Related Disabilities (ID/RD) Waiver (SC.0237, DDSN-operated) | $30.00since 2025-11-01 | Per installation | — | Paid by the state, outside plans | — | SCDHHS HCBS Waivers Fee Schedule (Effect |
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas ARChoices in Homecare 1915(c) waiver | $29.90since 2022-08-25 | — | — | Paid by the state, outside plans | — | Arkansas Medicaid ARChoices Fee Schedule |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $1.06since 2025-01-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service HCPC |
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 S5160?
It depends on the state. Of the 27 states with a published fee-for-service rate, the median is $53.96. Minnesota pays the most ($500.00 per Each Time) and New Mexico the least ($1.06).
Which state pays the highest Medicaid rate for S5160?
Minnesota, at $500.00 per Each Time, effective 2026-01-01.
Do managed-care plans pay the same rate for S5160?
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
96158Positive behavioral interventions and support · 40 statesT1017Targeted case management, each 15 minutes · 37 statesT1016Case management, each 15 minutes · 36 statesT1001Nursing assessment / evaluation · 35 statesT1005Respite care services, up to 15 minutes · 35 statesS5125Attendant care services; per 15 minutes · 34 statesS5170Home delivered meals, including preparation; per meal · 34 statesT2025Waiver services; not otherwise specified (nos) · 31 statesS5150Unskilled respite care, not hospice; per 15 minutes · 30 statesS5161Emergency response system; service fee, per month · 29 statesT2022Case management, per month · 28 statesG0101Respite care (daily) · 27 states
Track S5160 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.