Average Medicaid Personal Care Services Payments
Typical Medicaid Personal Care Services reimbursement across 1,847 cities
Avg. Medicaid Paid
$94.41
Price Range
$0.00 – $5,539
Total Claims
261.4M
Cities
1847
Typical Payment Range
Typical Medicaid Personal Care Services payments fall between $41.30 and $131.93 per claim (median: $76.58). The top 10% of payments exceed $303.40.
Based on per-provider averages across all Medicaid claims in this category.
About This Procedure
Medicaid-funded personal care services that help beneficiaries with activities of daily living, including bathing, dressing, grooming, and meal preparation.
Why do these costs look low?
These figures represent Medicaid reimbursement rates — the amounts that state Medicaid programs actually paid providers. Medicaid typically reimburses significantly less than private insurance or out-of-pocket prices. If you have private insurance or are paying cash, expect higher costs. See the cost components below for per-code averages.
Costs by City
| City | Avg. Paid | Min / Max | Claims | Providers |
|---|---|---|---|---|
| Stoughton, MA | $120.34 | $120.34 – $120.34 | 392,994 | 1 |
| Kissimmee, FL | $62.41 | $27.00 – $186.90 | 388,818 | 10 |
| Winston Salem, NC | $105.36 | $67.14 – $158.30 | 383,584 | 14 |
| Braintree, MA | $84.31 | $81.09 – $95.93 | 379,926 | 3 |
| Appleton, WI | $10.20 | $4.98 – $673.55 | 379,580 | 4 |
| Coral Gables, FL | $27.28 | $24.17 – $39.89 | 376,825 | 5 |
| Breaux Bridge, LA | $124.67 | $93.57 – $142.83 | 373,666 | 4 |
| Salina, KS | $82.76 | $22.51 – $4,328 | 372,574 | 7 |
| Quincy, MA | $76.29 | $54.14 – $660.29 | 368,797 | 6 |
| Metairie, LA | $132.95 | $67.37 – $150.41 | 365,445 | 10 |
| Wheeling, WV | $190.69 | $131.19 – $920.96 | 361,754 | 4 |
| Ahoskie, NC | $85.99 | $67.72 – $144.54 | 350,722 | 8 |
| Chattanooga, TN | $75.64 | $0.00 – $146.58 | 349,127 | 10 |
| Pembroke, NC | $110.90 | $101.55 – $139.25 | 343,365 | 10 |
| Lenexa, KS | $111.23 | $67.07 – $2,122 | 342,690 | 5 |
| Lawrence, MA | $111.34 | $4.56 – $113.67 | 341,169 | 4 |
| New Castle, DE | $499.51 | $0.00 – $913.57 | 340,204 | 6 |
| Cookeville, TN | $124.74 | $82.59 – $129.30 | 336,719 | 6 |
| Nogales, AZ | $100.02 | $100.02 – $100.02 | 336,289 | 1 |
| Grand Junction, CO | $47.24 | $0.00 – $370.69 | 326,636 | 15 |
| Harlingen, TX | $55.77 | $42.10 – $85.07 | 319,886 | 12 |
| Hollywood, FL | $36.49 | $3.14 – $109.13 | 318,648 | 10 |
| Martinsburg, WV | $208.80 | $67.98 – $2,176 | 318,358 | 6 |
| Brockton, MA | $147.78 | $25.46 – $505.02 | 314,666 | 5 |
| Honolulu, HI | $122.10 | $2.42 – $1,069 | 308,758 | 29 |
| Prescott Valley, AZ | $119.06 | $89.81 – $131.96 | 308,739 | 3 |
| Valdosta, GA | $93.24 | $93.24 – $93.24 | 307,234 | 1 |
| Pensacola, FL | $48.01 | $17.41 – $94.25 | 306,810 | 17 |
| West Allis, WI | $15.42 | $4.92 – $233.83 | 305,976 | 2 |
| Oshkosh, WI | $7.20 | $6.87 – $145.14 | 305,174 | 2 |
| Raleigh, NC | $116.81 | $27.51 – $164.44 | 304,920 | 23 |
| Hialeah Gardens, FL | $24.03 | $10.41 – $122.12 | 304,313 | 5 |
| Knoxville, TN | $115.53 | $91.19 – $137.29 | 303,093 | 9 |
| Richardson, TX | $57.79 | $47.93 – $283.73 | 300,360 | 8 |
| Davie, FL | $33.26 | $28.82 – $75.97 | 296,035 | 7 |
| Natchitoches, LA | $117.08 | $91.28 – $129.09 | 292,970 | 6 |
| Medley, FL | $55.51 | $28.21 – $63.94 | 292,610 | 3 |
| Pharr, TX | $75.21 | $43.15 – $91.56 | 289,031 | 8 |
| Wamego, KS | $78.88 | $75.94 – $2,204 | 282,984 | 2 |
| Columbia, SC | $19.89 | $16.93 – $161.76 | 275,288 | 12 |
| Boynton Beach, FL | $31.83 | $1.84 – $137.46 | 274,742 | 9 |
| Pineville, LA | $235.64 | $111.05 – $1,112 | 274,056 | 4 |
| Homestead, FL | $24.38 | $10.62 – $26.47 | 273,792 | 3 |
| Reidsville, NC | $121.35 | $121.33 – $127.86 | 268,738 | 2 |
| Marksville, LA | $118.19 | $39.14 – $124.25 | 265,486 | 3 |
| Barboursville, WV | $166.29 | $114.92 – $1,235 | 261,747 | 3 |
| Hays, KS | $86.64 | $20.11 – $5,308 | 260,802 | 3 |
| Greenacres, FL | $41.98 | $25.92 – $76.20 | 260,690 | 6 |
| Ball, LA | $120.34 | $90.80 – $138.00 | 259,179 | 3 |
| Houma, LA | $132.67 | $95.61 – $426.79 | 258,981 | 7 |
Cost Components
National averages for each billing code in this procedure category. Sorted by claim volume.
| Code | Description | Avg. Paid | Claims | Providers |
|---|---|---|---|---|
| S5125 | Attendant care service /15m | $78.74 | 398,071,209 | 3,041 |
| S5130 | Homaker service nos per 15m | $55.89 | 87,575,527 | 2,827 |
| S5126 | Attendant care service /diem | $90.43 | 49,138,345 | 71 |
| S5131 | Homemaker service nos /diem | $135.63 | 1,273,707 | 76 |
These averages group common billing codes used when providers bill Medicaid for this procedure. Individual costs will vary.