What is HCPCS code S5130?
S5130 is the HCPCS code for homemaker services billed per 15 minutes. The CMS descriptor, who pays for it, 2026 state rates and how to bill it right.
S5130 is the HCPCS code for homemaker services, billed in 15-minute units. It covers household help such as cleaning, laundry, shopping and meal preparation as defined by each state. Medicaid programs such as HCBS waivers pay it. Medicare does not.
What does the S5130 descriptor say?
The CMS long descriptor reads: “Homemaker service, nos; per 15 minutes” (CMS HCPCS quarterly update, October 2026 file). NOS means “not otherwise specified.” The code doesn’t list tasks, so the state’s waiver service definition sets what counts as homemaker work and what doesn’t.
| Field | Value |
|---|---|
| Unit | 15 minutes |
| Code added | January 1, 2003 |
| Medicare coverage code | I (not payable by Medicare) |
| Daily version | S5131 (per diem) |
How is homemaker different from personal care?
Homemaker services are help with the home. Personal care is hands-on help with the person, such as bathing, dressing and toileting, and is usually billed under T1019 or S5125. If a caregiver gives a bath and then does laundry, the state’s rules decide whether the visit is split across two codes or billed under one. See companion care vs. personal care.
How do S5130 rates vary by state?
Some states pay homemaker at the same rate as personal care. Others pay less.
| State and program | S5130 rate per 15 minutes | T1019 on same schedule | Effective |
|---|---|---|---|
| South Dakota, Personal Care Agency Fee Schedule | $11.17 | $11.17 | July 1, 2026 |
| Utah, Waiver for Individuals 65 and Older | $9.00 (U3 required) | $9.30 | July 1, 2026 |
Utah’s sheet also lists an optional TN rate for S5130 at 175% of base, $15.75. South Dakota says providers must append applicable modifiers and bill their usual and customary charge, with the schedule amount as the maximum.
What should you check before billing S5130?
Match the code, units and dates to the authorization, and keep task notes that show homemaker work was done.
- Service plan tasks. Bill only the homemaker tasks on the plan. Check your state’s rule on tasks done for other people in the household.
- Modifiers. Use the program and other modifiers your state lists. See home care billing modifiers.
- EVV. The Cures Act requires EVV for Medicaid personal care, and CMS says that covers any service that includes personal care, whatever it’s called (CMS EVV FAQ). Whether a homemaker-only visit needs EVV depends on how your state defines the service. Check the EVV state directory.
- Units. Convert minutes with the units calculator and apply your state’s rounding rule.
How Caregiver Scheduling handles this
Caregiver Scheduling warns you when a week goes over a client’s authorized hours (Growth and up). GPS check-in records actual times, and visit notes show which tasks were done. $199/month for up to 10 caregivers or $299/month for up to 50, with a 30-day free trial.
FAQ
What does NOS mean in the S5130 descriptor? Not otherwise specified. The state’s waiver defines the tasks.
Is S5130 billed per hour? No. Each unit is 15 minutes, so 1 hour is 4 units.
Does Medicare pay for homemaker services under S5130? No. CMS lists S5130 with coverage code I, not payable by Medicare.
General information, not billing or legal advice. Check your state Medicaid provider manual and fee schedule.