S5101
Day care services, adult, per half day
Day care services, adult, per half day is the #243 most-billed Medicaid procedure code, with $592.2M in payments across 7.8M claims from 2018–2024. The national median cost per claim is $66.43. Costs vary widely — the 90th percentile is $273.59 per claim, 4.1× the median.
Total Paid
$592.2M
0.05% of all spending
Total Claims
7.8M
Providers
695
Avg Cost/Claim
$75
National Cost Distribution
How much do providers bill per claim for S5101? Based on 667 providers billing this code nationally.
Median
$66.43
Average
$123.72
Std Dev
$130.76
Max
$677.97
Percentile Distribution (Cost per Claim)
50% of providers bill between $44.83 and $141.84 per claim for this code.
90% bill between $34.65 and $273.59.
Top 1% bill above $611.41.
About This Procedure
HCPCS code S5101 (Day care services, adult, per half day) was billed by 695 providers across 7.8M claims, totaling $592.2M in Medicaid payments from 2018–2024. This code was used for 1.1M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$66.43
Providers Billing
667
National Spending
$592.2M
Avg/Median Ratio
1.86×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for S5101
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1801093752 | $13.3M |
| 2 | 1992829287 | $11.9M |
| 3 | 1982153144 | $8.6M |
| 4 | 1205298965 | $6.9M |
| 5 | 1629197033 | $5.7M |
| 6 | 1992864458 | $5.2M |
| 7 | 1982892766 | $5.1M |
| 8 | 1487907861 | $5.0M |
| 9 | 1801231360 | $4.9M |
| 10 | 1407162167 | $4.9M |
| 11 | 1750637351 | $4.8M |
| 12 | 1386198315 | $4.7M |
| 13 | 1912196551 | $4.6M |
| 14 | 1457573230 | $4.5M |
| 15 | 1174844799 | $4.4M |
| 16 | 1285152694 | $4.1M |
| 17 | 1609916758 | $4.0M |
| 18 | 1063674083 | $3.8M |
| 19 | 1104971597 | $3.8M |
| 20 | 1538297478 | $3.7M |
Showing top 20 of 695 providers billing this code