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#574 of 11K

S5151

Unskilled respite care, per diem

Unskilled respite care, per diem is the #574 most-billed Medicaid procedure code, with $141.4M in payments across 912K claims from 2018–2024. The national median cost per claim is $249.18. Costs vary widely — the 90th percentile is $556.44 per claim, 2.2× the median.

Total Paid

$141.4M

0.01% of all spending

Total Claims

912K

Providers

288

Avg Cost/Claim

$155

National Cost Distribution

How much do providers bill per claim for S5151? Based on 230 providers billing this code nationally.

Median

$249.18

Average

$294.34

Std Dev

$222.26

Max

$1,198.03

Percentile Distribution (Cost per Claim)

p10
$59.97
p25
$171.07
Median
$249.18
p75
$351.80
p90
$556.44
p95
$800.92
p99
$1,084.11

50% of providers bill between $171.07 and $351.80 per claim for this code.

90% bill between $59.97 and $556.44.

Top 1% bill above $1,084.11.

About This Procedure

HCPCS code S5151 (Unskilled respite care, per diem) was billed by 288 providers across 912K claims, totaling $141.4M in Medicaid payments from 2018–2024. This code was used for 219K unique beneficiaries.

Risk Assessment

This procedure is featured in our investigation: NY Home Care Machine

Read the full analysis for context on billing patterns associated with this code.

Billing Statistics

Median Cost/Claim

$249.18

Providers Billing

230

National Spending

$141.4M

Avg/Median Ratio

1.18×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for S5151

#ProviderTotal Paid
1Help At Home, Llc

Merrillville Bra, IN · Home Health

$18.8M
21124321500$7.8M
31700174901$5.0M
41043300882$4.8M
5Arion Care Solutions Llc

Chandler, AZ · In Home Supportive Care

$4.0M
61326579723$3.3M
7Colorado Family Caregivers Llc

Colorado Springs, CO · In Home Supportive Care

$2.7M
8Community Ventures In Living, Ltd.

Lafayette, IN · Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

$2.7M
91598992885$2.6M
101508071226$2.3M
111215087994$2.2M
121033362678$2.1M
13The Arc Of Oakland County Inc

Troy, MI · Voluntary or Charitable

$2.0M
141942345178$2.0M
151225458284$1.9M
16Integrated Life Choices

Littleton, CO · Clinic/Center, Developmental Disabilities

$1.9M
171295927614$1.6M
181861706319$1.6M
1924hr Homecare

El Segundo, CA · Technician, Personal Care Attendant

$1.6M
201508989666$1.6M

Showing top 20 of 288 providers billing this code