S5105
Day care services, adult, per hour
Day care services, adult, per hour is the #119 most-billed Medicaid procedure code, with $1.66B in payments across 21.2M claims from 2018–2024. The national median cost per claim is $72.81. Costs vary widely — the 90th percentile is $304.11 per claim, 4.2× the median.
Total Paid
$1.66B
0.15% of all spending
Total Claims
21.2M
Providers
494
Avg Cost/Claim
$78
National Cost Distribution
How much do providers bill per claim for S5105? Based on 492 providers billing this code nationally.
Median
$72.81
Average
$171.74
Std Dev
$345.65
Max
$2,084.91
Percentile Distribution (Cost per Claim)
50% of providers bill between $63.70 and $86.45 per claim for this code.
90% bill between $57.23 and $304.11.
Top 1% bill above $2,000.00.
About This Procedure
HCPCS code S5105 (Day care services, adult, per hour) was billed by 494 providers across 21.2M claims, totaling $1.66B in Medicaid payments from 2018–2024. This code was used for 2.0M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$72.81
Providers Billing
492
National Spending
$1.66B
Avg/Median Ratio
2.36×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for S5105
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1154802247 | $28.7M |
| 2 | 1457746653 | $25.8M |
| 3 | 1881930162 | $25.0M |
| 4 | 1396223780 | $23.6M |
| 5 | 1316315179 | $23.5M |
| 6 | 1073858866 | $22.6M |
| 7 | 1124091020 | $22.4M |
| 8 | 1851641500 | $20.7M |
| 9 | 1194271510 | $18.9M |
| 10 | 1629620224 | $18.7M |
| 11 | 1427580158 | $18.0M |
| 12 | 1982962726 | $17.5M |
| 13 | 1942703574 | $16.8M |
| 14 | 1780233288 | $15.4M |
| 15 | 1124475900 | $15.3M |
| 16 | 1245709831 | $14.6M |
| 17 | 1649537960 | $14.4M |
| 18 | 1932540796 | $14.3M |
| 19 | 1497276588 | $14.2M |
| 20 | 1902355431 | $14.2M |
Showing top 20 of 494 providers billing this code