S5161 Medicaid reimbursement rates by state
Emergency response system; service fee, per month. 12 state Medicaid programs publish a fee-for-service rate for S5161 at the agency level. Rates run from $20.00 in Massachusetts to $110.14 in Minnesota, with a median of $36.66.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 12
- Median rate
- $36.66units vary by state
- Highest
- $110.14Minnesota
- Medicare (non-facility)
- —not on the physician fee schedule
S5161 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 |
|---|---|---|---|---|---|---|
| MinnesotaAgency provider · Minnesota Community First Services and Supports (CFSS) | $110.14since 2026-04-01 | month | — | Paid by the state, outside plans | — | Long-Term Services and Supports Service |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Community Integration and Habilitation (CIH) Waiver for people with IDD | $54.41since 2023-07-01 | month | — | Paid by the state, outside plans | — | IHCP Professional Fee Schedule (Last Upd |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $48.00since 2025-01-01 | month | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| FloridaAny qualified provider (rate does not vary by provider) · Florida iBudget waiver for people with developmental disabilities (APD) | $44.26since 2026-07-01 | unit | — | Paid by the state, outside plans | — | Florida Medicaid Developmental Disabilit |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina CAP consumer-directed option (CAP/CD) | $41.66since 2024-11-01 | month | — | Paid by the state, outside plans | — | NC Medicaid fee schedule 'CAP- Consumer |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Independent Care Waiver Program (adults with physical disabilities or brain injury) | $40.36since 2024-07-01 | month | — | Paid by the state, outside plans | — | Part II Policies and Procedures: Indepen |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Home Care Waiver (ODM) | $32.95since 2026-04-17 | Per monthly fee | — | Plans negotiate; applies out of network | — | OAC 5160-46-06 (Register of Ohio final f |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Community Long Term Care waivers (Community Choices, HIV/AIDS, Mechanical Ventilator Dependent; 1915(c)) | $30.00since 2025-11-01 | month | — | Paid by the state, outside plans | — | SCDHHS HCBS Waivers Fee Schedule (Effect |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $29.70since 2011-07-01 | month | — | Plans negotiate; applies out of network | — | DMAS procedure fee file hcpcmedical.csv |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Persons with Brain Injury waiver (DHS-DRS Home Services Program, IL.0329) | $28.00since 2026-07-01 | MO | — | Plans must pay at least this | — | HSP Rates and Fees (Medicaid Waiver Serv |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana New Opportunities Waiver (NOW, OCDD/OIDD 1915(c) waiver for people with intellectual/developmental disabilities) | $27.00since 2025-11-18 | month | — | Paid by the state, outside plans | — | New Opportunities Waiver rate and proced |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $20.00since 2026-03-01 | month | — | Plans negotiate; applies out of network | — | Rates for Durable Medical Equipment, Oxy |
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 S5161?
It depends on the state. Of the 12 states with a published fee-for-service rate, the median is $36.66. Minnesota pays the most ($110.14 per month) and Massachusetts the least ($20.00 per month).
Which state pays the highest Medicaid rate for S5161?
Minnesota, at $110.14 per month, effective 2026-04-01.
Do managed-care plans pay the same rate for S5161?
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.