Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#5 of 11K

S5125

Attendant care services, per 15 min

Attendant care services, per 15 min is the #5 most-billed Medicaid procedure code, with $31.34B in payments across 398.1M claims from 2018–2024. The national median cost per claim is $82.34. Costs vary widely — the 90th percentile is $272.73 per claim, 3.3× the median.

Total Paid

$31.34B

2.87% of all spending

Total Claims

398.1M

Providers

5K

Avg Cost/Claim

$79

National Cost Distribution

How much do providers bill per claim for S5125? Based on 4K providers billing this code nationally.

Median

$82.34

Average

$194.39

Std Dev

$490.31

Max

$8,024.53

Percentile Distribution (Cost per Claim)

p10
$35.71
p25
$55.40
Median
$82.34
p75
$132.45
p90
$272.73
p95
$661.59
p99
$2,709.30

50% of providers bill between $55.40 and $132.45 per claim for this code.

90% bill between $35.71 and $272.73.

Top 1% bill above $2,709.30.

About This Procedure

HCPCS code S5125 (Attendant care services, per 15 min) was billed by 5K providers across 398.1M claims, totaling $31.34B in Medicaid payments from 2018–2024. This code was used for 19.4M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$82.34

Providers Billing

4K

National Spending

$31.34B

Avg/Median Ratio

2.36×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for S5125

#ProviderTotal Paid
1Girling Health Care Inc.

Austin, TX · Home Health

$798.0M
2Acumen Fiscal Agent Llc

Mesa, AZ · Community/Behavioral Health

$676.0M
3Public Partnerships Llc

Alpharetta, GA · Supports Brokerage

$448.1M
4Mississippi Department Of Rehabilitaion Svs

Jackson, MS · Case Management

$295.6M
5Advance Hi-tech Nursing Inc.

San Antonio, TX · Technician Personal Care Attendant

$289.8M
6Guardiantrac. Llc

Sturgis, MI · Community/Behavioral Health

$262.5M
7Arion Care Solutions Llc

Chandler, AZ · In Home Supportive Care

$261.7M
8Ability360, Inc,

Phoenix, AZ · Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

$258.4M
9Legacy Home Health Agency, Inc.

Corpus Christi, TX · Home Health

$238.7M
10Chartwell Community Services Inc.

Arlington, TX · Home Health

$236.5M
11Instant Care Of Arizona

Phoenix, AZ · Home Health

$220.9M
12Texas Home Health Of America L.p.

Dallas, TX · Home Health

$206.6M
13Public Partnerships Llc

Latham, NY · Supports Brokerage

$205.2M
14Rem Community Options Inc.

Benwood, WV · Community/Behavioral Health

$188.4M
15Saint Benedicts Home Health, Inc.

Robstown, TX · Day Training, Developmentally Disabled Services

$184.6M
16Voca Corporation Of West Virginia Inc.

Princeton, WV · Clinic/Center Developmental Disabilities

$160.0M
17Jhc Operations Llc

Mount Vernon, TX · Home Health

$146.3M
18Rscr West Virginia Inc.

Parkersburg, WV · Clinic/Center Developmental Disabilities

$144.1M
19Alegre Home Health Care Llc

Mission, TX · Nursing Care

$141.5M
20Health Managment Of Kansas, Inc.

Coffeyville, KS · Home Health

$138.3M

Showing top 20 of 5K providers billing this code