S5100
Day care services, adult, per half day
Day care services, adult, per half day is the #115 most-billed Medicaid procedure code, with $1.73B in payments across 16.1M claims from 2018–2024. The national median cost per claim is $67.58. Costs vary widely — the 90th percentile is $250.88 per claim, 3.7× the median.
Total Paid
$1.73B
0.16% of all spending
Total Claims
16.1M
Providers
1K
Avg Cost/Claim
$107
National Cost Distribution
How much do providers bill per claim for S5100? Based on 1K providers billing this code nationally.
Median
$67.58
Average
$147.40
Std Dev
$285.19
Max
$2,707.40
Percentile Distribution (Cost per Claim)
50% of providers bill between $54.03 and $84.75 per claim for this code.
90% bill between $37.26 and $250.88.
Top 1% bill above $1,485.99.
About This Procedure
HCPCS code S5100 (Day care services, adult, per half day) was billed by 1K providers across 16.1M claims, totaling $1.73B in Medicaid payments from 2018–2024. This code was used for 1.6M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$67.58
Providers Billing
1K
National Spending
$1.73B
Avg/Median Ratio
2.18×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for S5100
| # | Provider | Total Paid |
|---|---|---|
| 1 | Commonwealth Of Mass-dds Hyde Park, MA · Case Management | $61.5M |
| 2 | Commonwealth Of Massachusetts Haverhill, MA · Case Management | $52.4M |
| 3 | Rehabilitation Centers Llc Magee, MS · Respite Care | $37.7M |
| 4 | Commonwealth Of Mass-dds Walpole, MA · Case Management | $33.9M |
| 5 | Commonwealth Of Massachusetts-dds S Weymouth, MA · Case Management | $33.5M |
| 6 | Department Of Developmental Services Fitchburg, MA · Case Management | $32.5M |
| 7 | Department Of Developmental Services Springfield, MA · Case Management | $31.2M |
| 8 | Rem East Llc Flowood, MS · Community/Behavioral Health | $30.5M |
| 9 | Brandi's Hope Community Services Magee, MS · Day Training Developmentally Disabled Services | $30.3M |
| 10 | Commonwealth Of Massachusetts-dds Brockton, MA · Case Management | $26.5M |
| 11 | Commonwealth Of Mass-dds Framingham, MA · Case Management | $26.2M |
| 12 | Commonwealth Of Massachusetts Lowell, MA · Case Management | $25.1M |
| 13 | Commonwealth Of Mass-dds Somerville, MA · Case Management | $24.4M |
| 14 | 1982610572 | $20.8M |
| 15 | Commonwealth Of Massachusetts-dds Plymouth, MA · Case Management | $20.3M |
| 16 | Commonwealth Of Massachusets Beverly, MA · Case Management | $19.4M |
| 17 | Department Of Developmental Services Northampton, MA · Case Management | $19.3M |
| 18 | Commonwealth Of Massachusetts Arlington, MA · Case Management | $19.3M |
| 19 | Department Of Developmental Services Pittsfield, MA · Case Management | $19.0M |
| 20 | Commonwealth Of Massachusetts Wakefield, MA · Case Management | $18.8M |
Showing top 20 of 1K providers billing this code