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#45 of 11K

S5126

Attendant care services, per diem

Attendant care services, per diem is the #45 most-billed Medicaid procedure code, with $4.44B in payments across 49.1M claims from 2018–2024. The national median cost per claim is $156.98. Costs vary widely — the 90th percentile is $939.56 per claim, 6.0× the median.

Total Paid

$4.44B

0.41% of all spending

Total Claims

49.1M

Providers

81

Avg Cost/Claim

$90

National Cost Distribution

How much do providers bill per claim for S5126? Based on 80 providers billing this code nationally.

Median

$156.98

Average

$348.81

Std Dev

$447.77

Max

$2,384.39

Percentile Distribution (Cost per Claim)

p10
$29.93
p25
$64.41
Median
$156.98
p75
$357.56
p90
$939.56
p95
$1,260.26
p99
$1,884.93

50% of providers bill between $64.41 and $357.56 per claim for this code.

90% bill between $29.93 and $939.56.

Top 1% bill above $1,884.93.

About This Procedure

HCPCS code S5126 (Attendant care services, per diem) was billed by 81 providers across 49.1M claims, totaling $4.44B in Medicaid payments from 2018–2024. This code was used for 2.0M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$156.98

Providers Billing

80

National Spending

$4.44B

Avg/Median Ratio

2.22×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for S5126

#ProviderTotal Paid
1Public Partnerships Llc

Latham, NY · Supports Brokerage

$2.37B
2Consumer Direct Care Network Virginia

Missoula, MT · Home Health

$1.77B
3Northeast Pennsylvania Center For Independent Living

Scranton, PA · Supports Brokerage

$135.5M
4Guardiantrac. Llc

Sturgis, MI · Community/Behavioral Health

$68.6M
51033706437$30.9M
61750657888$11.6M
7Avondale Care Group Llc

New York, NY · Home Health

$7.7M
81669821963$7.1M
9New Partners Inc

New York, NY · Home Health

$3.7M
101518337286$2.9M
111497231583$2.7M
121518085851$2.1M
13Premier Home Health Care Services Inc

New York, NY · Home Health

$1.9M
141154456366$1.9M
151003414913$1.8M
161457742967$1.7M
17Alliance For Health

Brooklyn, NY · In Home Supportive Care

$1.5M
181265944854$1.4M
191194975326$1.1M
201528088853$1.0M

Showing top 20 of 81 providers billing this code