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#580 of 11K

S5111

Home care training, family member, per session

Home care training, family member, per session is the #580 most-billed Medicaid procedure code, with $139.4M in payments across 1.3M claims from 2018–2024. The national median cost per claim is $87.13. Costs vary widely — the 90th percentile is $214.23 per claim, 2.5× the median.

Total Paid

$139.4M

0.01% of all spending

Total Claims

1.3M

Providers

406

Avg Cost/Claim

$107

National Cost Distribution

How much do providers bill per claim for S5111? Based on 389 providers billing this code nationally.

Median

$87.13

Average

$109.41

Std Dev

$90.48

Max

$1,131.43

Percentile Distribution (Cost per Claim)

p10
$35.63
p25
$58.21
Median
$87.13
p75
$134.49
p90
$214.23
p95
$275.10
p99
$354.87

50% of providers bill between $58.21 and $134.49 per claim for this code.

90% bill between $35.63 and $214.23.

Top 1% bill above $354.87.

About This Procedure

HCPCS code S5111 (Home care training, family member, per session) was billed by 406 providers across 1.3M claims, totaling $139.4M in Medicaid payments from 2018–2024. This code was used for 572K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$87.13

Providers Billing

389

National Spending

$139.4M

Avg/Median Ratio

1.26×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for S5111

#ProviderTotal Paid
11770889594$8.6M
2California Psychcare, Inc.

Van Nuys, CA · Behavior Analyst

$6.5M
31932709771$5.9M
4Macomb County Community Mental Health

Clinton Twp, MI · Clinic/Center Mental Health (Including Community Mental Health Center)

$5.0M
51336391911$4.1M
6Bm Behavioral Center Llc

San Pablo, CA · Home Health

$3.1M
7Genesee Health System

Flint, MI · Community/Behavioral Health

$2.9M
81275131005$2.9M
91104426352$2.6M
101033271895$2.5M
111710066253$2.4M
121467520452$2.4M
13Community Mental Health For Central Michigan

Mt Pleasant, MI · Psychiatry & Neurology Psychiatry

$2.3M
141598388993$2.1M
151598719395$2.0M
16Macomb Oakland Regional Center Inc.

Auburn Hills, MI · Community/Behavioral Health

$1.9M
171184139131$1.9M
181952559296$1.9M
191528198975$1.8M
20St Clair County Community Mental Health Authority

Port Huron, MI · Community/Behavioral Health

$1.8M

Showing top 20 of 406 providers billing this code