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#573 of 11K

S9125

Respite care, in the home, per diem

Respite care, in the home, per diem is the #573 most-billed Medicaid procedure code, with $141.9M in payments across 898K claims from 2018–2024. The national median cost per claim is $187.28. Costs vary widely — the 90th percentile is $571.22 per claim, 3.1× the median.

Total Paid

$141.9M

0.01% of all spending

Total Claims

898K

Providers

74

Avg Cost/Claim

$158

National Cost Distribution

How much do providers bill per claim for S9125? Based on 71 providers billing this code nationally.

Median

$187.28

Average

$291.45

Std Dev

$337.43

Max

$1,774.97

Percentile Distribution (Cost per Claim)

p10
$84.34
p25
$123.77
Median
$187.28
p75
$266.99
p90
$571.22
p95
$1,021.85
p99
$1,598.51

50% of providers bill between $123.77 and $266.99 per claim for this code.

90% bill between $84.34 and $571.22.

Top 1% bill above $1,598.51.

About This Procedure

HCPCS code S9125 (Respite care, in the home, per diem) was billed by 74 providers across 898K claims, totaling $141.9M in Medicaid payments from 2018–2024. This code was used for 155K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$187.28

Providers Billing

71

National Spending

$141.9M

Avg/Median Ratio

1.56×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for S9125

#ProviderTotal Paid
1Not Found

Unknown, Unknown · Unknown

$22.5M
2Consumer Directed Services In Texas Inc.

San Antonio, TX · Supports Brokerage

$20.7M
31700174901$11.8M
4Caregivers Home Health Tx Inc

Richardson, TX · Nursing Care

$11.5M
5Segnik Group Inc

Houston, TX · Supports Brokerage

$5.2M
6New Jersey Division Of Developmental Disabilities

Hamilton, NJ · Day Training Developmentally Disabled Services

$4.9M
71487960167$4.9M
8Dungarvin Minnesota Llc

Mendota Heights, MN · Community/Behavioral Health

$4.8M
91285217364$4.2M
10Acumen Fiscal Agent Llc

Mesa, AZ · Community/Behavioral Health

$4.0M
111124158175$3.8M
12Alamo Consumer Direct, Llc

Austin, TX · Supports Brokerage

$3.4M
13Astrocare Class, Inc.

Houston, TX · Home Health

$3.4M
14In-home Attendant Services Ltd.

Houston, TX · Technician Personal Care Attendant

$3.3M
151083349781$3.3M
161346572690$3.2M
171568619484$2.9M
181336177492$2.5M
191225286081$2.5M
20Eak Good Neighbor Properties

Mount Vernon, TX · Day Training, Developmentally Disabled Services

$2.1M

Showing top 20 of 74 providers billing this code