S5102 HCPCS Code: Day care services (Units, EVV, Rates, Denials)
S5102: Day care services, adult, per diem. Billing unit, which services it covers, modifiers, whether EVV applies, typical rate notes by state and the common denial reasons.
S5102 is “Day care services, adult; per diem.” It is billed per day and covers a day of attendance at an adult day center. Medicare does not pay it. EVV does not apply, because the service is delivered at the center, not in the home.
Units and rounding
One unit is one day. The state’s service definition sets what counts as a billable day of adult day attendance, such as a minimum number of hours. Don’t bill an hourly or 15-minute code for the same service on the same day unless the program allows it.
Modifiers you will see
- U1–U9: State-defined; often distinguish programs (waiver vs state plan), service levels or provider types
- TF / TG: Intermediate or complex level of care, where the state uses levels
Modifier meanings are set by each state and payer, so check your provider manual. See home care billing modifiers.
Typical rates
Adult day rates are set per state program and managed-care plan, and some states pay a higher daily rate for health-model (medical) adult day. Each state program and managed-care plan sets its own rate, so use your state’s current fee schedule.
Common denial reasons
- Attendance shorter than the state’s minimum for a full day
- Daily and 15-minute or half-day codes billed for the same date
- Days exceed the authorization
- Service date outside the authorization period
Related codes
Source
CMS HCPCS Level II code set (quarterly update). Confirm the exact descriptor and any state-specific unit definition in your payer’s billing manual. Last reviewed November 6, 2026.
General information, not billing or legal advice. Check your state Medicaid agency’s current fee schedule and provider manual.