S5131
Homemaker service, NOS, per diem
Homemaker service, NOS, per diem is the #512 most-billed Medicaid procedure code, with $172.8M in payments across 1.3M claims from 2018–2024. The national median cost per claim is $102.01. Costs vary widely — the 90th percentile is $740.95 per claim, 7.3× the median.
Total Paid
$172.8M
0.02% of all spending
Total Claims
1.3M
Providers
79
Avg Cost/Claim
$136
National Cost Distribution
How much do providers bill per claim for S5131? Based on 75 providers billing this code nationally.
Median
$102.01
Average
$303.43
Std Dev
$612.49
Max
$4,631.35
Percentile Distribution (Cost per Claim)
50% of providers bill between $53.13 and $267.55 per claim for this code.
90% bill between $25.83 and $740.95.
Top 1% bill above $2,340.97.
About This Procedure
HCPCS code S5131 (Homemaker service, NOS, per diem) was billed by 79 providers across 1.3M claims, totaling $172.8M in Medicaid payments from 2018–2024. This code was used for 116K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$102.01
Providers Billing
75
National Spending
$172.8M
Avg/Median Ratio
2.97×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for S5131
| # | Provider | Total Paid |
|---|---|---|
| 1 | Guardiantrac. Llc Sturgis, MI · Community/Behavioral Health | $33.7M |
| 2 | 1245752633 | $21.2M |
| 3 | 1154663094 | $12.9M |
| 4 | 1447203856 | $12.7M |
| 5 | 1801038757 | $9.2M |
| 6 | 1699012799 | $8.2M |
| 7 | 1851395180 | $7.8M |
| 8 | Not Found Unknown, Unknown · Unknown | $7.1M |
| 9 | 1295214179 | $4.3M |
| 10 | 1649367939 | $3.9M |
| 11 | 1952542623 | $3.6M |
| 12 | 1578818845 | $3.4M |
| 13 | 1134357601 | $3.3M |
| 14 | 1417934654 | $3.3M |
| 15 | 1942332846 | $3.0M |
| 16 | 1720386378 | $2.8M |
| 17 | 1275972408 | $2.7M |
| 18 | 1679634216 | $2.6M |
| 19 | 1629505730 | $2.6M |
| 20 | 1255879821 | $2.5M |
Showing top 20 of 79 providers billing this code