S5136
Companion care, adult, per 15 minutes
Companion care, adult, per 15 minutes is the #88 most-billed Medicaid procedure code, with $2.24B in payments across 6.4M claims from 2018–2024. The national median cost per claim is $302.34. Costs vary widely — the 90th percentile is $5,075.87 per claim, 16.8× the median.
Total Paid
$2.24B
0.21% of all spending
Total Claims
6.4M
Providers
200
Avg Cost/Claim
$353
National Cost Distribution
How much do providers bill per claim for S5136? Based on 196 providers billing this code nationally.
Median
$302.34
Average
$1,438.71
Std Dev
$2,102.61
Max
$9,824.42
Percentile Distribution (Cost per Claim)
50% of providers bill between $107.61 and $2,109.68 per claim for this code.
90% bill between $16.76 and $5,075.87.
Top 1% bill above $7,598.28.
About This Procedure
HCPCS code S5136 (Companion care, adult, per 15 minutes) was billed by 200 providers across 6.4M claims, totaling $2.24B in Medicaid payments from 2018–2024. This code was used for 407K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$302.34
Providers Billing
196
National Spending
$2.24B
Avg/Median Ratio
4.76×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for S5136
| # | Provider | Total Paid |
|---|---|---|
| 1 | Consumer Direct Care Network Virginia Missoula, MT · Home Health | $93.9M |
| 2 | Brandi's Hope Community Services Magee, MS · Day Training Developmentally Disabled Services | $90.3M |
| 3 | Dac, Inc Maquoketa, IA · Community/Behavioral Health | $83.4M |
| 4 | Systems Unlimited Inc. Iowa City, IA · Day Training Developmentally Disabled Services | $82.7M |
| 5 | Rem Iowa Community Services Inc. Hiawatha, IA · Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities | $77.0M |
| 6 | Hope Haven Inc Rock Valley, IA · Nursing Facility/Intermediate Care Facility | $76.6M |
| 7 | 1558528463 | $63.8M |
| 8 | Rem East Llc Flowood, MS · Community/Behavioral Health | $58.5M |
| 9 | Discovery Living Inc. Cedar Rapids, IA · Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities | $58.0M |
| 10 | National Mentor Services Llc Saint Louis, MO · Case Management | $55.7M |
| 11 | Rehabilitation Centers Llc Magee, MS · Respite Care | $54.2M |
| 12 | Boswell Regional Center Magee, MS · Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities | $48.5M |
| 13 | Rem Missouri Llc Saint Louis, MO · Clinic/Center Developmental Disabilities | $45.3M |
| 14 | Exceptional Persons Inc Waterloo, IA · Day Training, Developmentally Disabled Services | $44.8M |
| 15 | 1508955485 | $43.0M |
| 16 | Trivium Life Services Council Bluffs, IA · Day Training, Developmentally Disabled Services | $41.8M |
| 17 | Handicapped Development Center Davenport, IA · Day Training, Developmentally Disabled Services | $41.3M |
| 18 | Link Associates West Des Moines, IA · Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities | $40.9M |
| 19 | 1790846319 | $38.8M |
| 20 | 1285729418 | $33.2M |
Showing top 20 of 200 providers billing this code