#157 of 11K

S5145

Foster care, therapeutic, child, per diem

Foster care, therapeutic, child, per diem is the #157 most-billed Medicaid procedure code, with $1.12B in payments across 6.2M claims from 2018–2024. The national median cost per claim is $216.31. Costs vary widely — the 90th percentile is $1,270.95 per claim, 5.9× the median.

Total Paid

$1.12B

0.10% of all spending

Total Claims

6.2M

Providers

227

Avg Cost/Claim

$180

National Cost Distribution

How much do providers bill per claim for S5145? Based on 224 providers billing this code nationally.

Median

$216.31

Average

$577.17

Std Dev

$736.13

Max

$4,749.33

Percentile Distribution (Cost per Claim)

p10

$62.61

p25

$111.96

Median

$216.31

p75

$795.48

p90

$1,270.95

p95

$1,788.71

p99

$3,719.34

50% of providers bill between $111.96 and $795.48 per claim for this code.

90% bill between $62.61 and $1,270.95.

Top 1% bill above $3,719.34.

About This Procedure

HCPCS code S5145 (Foster care, therapeutic, child, per diem) was billed by 227 providers across 6.2M claims, totaling $1.12B in Medicaid payments from 2018–2024. This code was used for 442K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$216.31

Providers Billing

224

National Spending

$1.12B

Avg/Median Ratio

2.67×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for S5145

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	The Bair Foundation Las Cruces, NM · Community/Behavioral Health	$46.9M	$2,530.38	11.7× median	Top 10%
2	1689986226	$35.3M	$138.06	0.6× median	Below Median
3	1801918966	$34.6M	$144.10	0.7× median	Below Median
4	1720247570	$33.3M	$162.60	0.8× median	Below Median
5	Aware Inc Anaconda, MT · Behavior Analyst	$28.1M	$190.08	0.9× median	Below Median
6	1518060318	$26.5M	$132.69	0.6× median	Below Median
7	1750431623	$22.9M	$193.09	0.9× median	Below Median
8	1154475317	$22.7M	$1,382.56	6.4× median	Top 10%
9	1477864734	$21.2M	$158.28	0.7× median	Below Median
10	Sco Family Of Services Garden City, NY · Foster Care Agency	$20.0M	$1,795.73	8.3× median	Top 10%
11	The Children's Aid Society Brooklyn, NY · Foster Care Agency	$20.0M	$1,282.64	5.9× median	Top 10%
12	1780850685	$19.3M	$155.05	0.7× median	Below Median
13	1427507706	$18.9M	$743.79	3.4× median	Above Median
14	1790789501	$17.7M	$48.93	0.2× median	Below Median
15	1740410091	$17.3M	$243.82	1.1× median	Above Median
16	1760525992	$15.6M	$1,162.01	5.4× median	Above 75th
17	1477672988	$15.4M	$233.24	1.1× median	Above Median
18	1033287289	$14.7M	$167.79	0.8× median	Below Median
19	1639267933	$14.5M	$100.06	0.5× median	Below Median
20	1265540884	$14.2M	$241.52	1.1× median	Above Median

Showing top 20 of 227 providers billing this code

Related Procedures

S5140Foster care, adult; per diem$6.39B S5150Unskilled respite care, per 15 min$2.98B S5136Companion care, adult, per 15 minutes$2.24B S5135Companion care, adult, per diem$1.77B S5151Unskilled respite care, per diem$141.4M

← All procedures Top providers →