What is HCPCS code S5131?
S5131 is the HCPCS code for homemaker services billed per diem. The CMS descriptor, how it differs from S5130, and what to confirm before billing a day.
S5131 is the HCPCS code for homemaker services billed per diem, one unit per day. It is the daily version of S5130, which is billed in 15-minute units. Only programs that price homemaker services by the day use it. Medicare does not pay it.
What does the S5131 descriptor say?
The CMS long descriptor reads: “Homemaker service, nos; per diem” (CMS HCPCS quarterly update, October 2026 file). NOS means “not otherwise specified,” so the state’s waiver decides which household tasks are covered.
| Field | S5130 | S5131 |
|---|---|---|
| Unit | 15 minutes | Per diem (1 day) |
| Code added | January 1, 2003 | January 1, 2003 |
| Medicare coverage code | I (not payable by Medicare) | I (not payable by Medicare) |
How often is S5131 used?
Less often than the 15-minute code, in the schedules we checked. They pay homemaker services by the unit under S5130. For example, South Dakota’s Personal Care Agency Fee Schedule lists S5130 at $11.17 per 15 minutes and Utah’s Waiver for Individuals 65 and Older rate sheet lists it at $9.00 per 15 minutes, both effective July 1, 2026. Neither lists S5131.
If your state does list S5131, the service definition matters more than the code. Look for:
- what counts as a billable day (a minimum amount of work, or simply any service that day)
- whether the day rate replaces hourly homemaker billing for that client
- required modifiers
- documentation the state expects for each day
Search your state’s programs in the Medicaid waiver lookup.
How do you bill S5131 correctly?
Bill 1 unit for each day that meets the state’s definition, within the authorized dates.
- Match the authorization. It should name S5131 and a number of days. If it names S5130 units, bill S5130.
- Keep daily task notes. Record the homemaker tasks done each day, tied to the service plan.
- Mind the date range. Days outside the authorization usually aren’t payable. See authorization tracking.
- Keep homemaker and personal care separate. Hands-on care belongs under a personal care or attendant code. See companion care vs. personal care.
- Check modifiers. See home care billing modifiers.
FAQ
How many S5131 units do I bill for 5 days of homemaker service? Five, one per qualifying day.
Can I bill S5130 and S5131 for the same client? Only if your state’s rules allow both. Check the authorization, which names the code and unit you can bill.
Does Medicare cover S5131? No. CMS lists it with coverage code I, not payable by Medicare.
General information, not billing or legal advice. Check your state Medicaid provider manual and fee schedule.