Authorizations
How Do 15-Minute Medicaid Billing Units Work for Home Care?
Four units equal one hour. How to convert units to hours, the common HCPCS codes, how states round partial units, and how to stay inside the authorization.
Will the authorization cover these visits?
Enter the units on the authorization letter and the visits you plan. You'll see how many units each visit bills, whether the plan fits, and the longest visit you can schedule without going over.
Last reviewed November 6, 2026
How your state roundsRounding rules vary by state and program. Your state's Medicaid billing manual says which applies.
The answer
Enter the units on the authorization, the visit length and the number of visits.
Quick reference
Minutes to units under the 8-minute rule.
One unit is 15 minutes for T1019, S5125, S5130, S5135, S5150 and most T2025 waiver codes. Under the 8-minute rule, leftover minutes of 8 or more round up to one more unit and 7 or fewer are dropped. Not every state uses it. Rounding is applied to each visit, not the weekly total.
| Minutes | Units | Minutes | Units |
|---|---|---|---|
| 8 to 22 | 1 | 68 to 82 | 5 |
| 23 to 37 | 2 | 83 to 97 | 6 |
| 38 to 52 | 3 | 98 to 112 | 7 |
| 53 to 67 | 4 | 113 to 127 | 8 |
How Caregiver Scheduling handles this
Caregiver Scheduling checks every visit against the client’s authorized hours as you schedule, and warns you when a week would go over. Authorized-hours checks are on Growth and up. See authorization caps.
Sources
Frequently asked questions
One. Medicaid home care codes such as T1019, S5125, S5130 and S5150 are billed in 15-minute units, so a 2-hour visit is 8 units and a 1-hour 20-minute visit is 5 units under the 8-minute rule (80 minutes = 5 units + 5 leftover minutes, which do not round up).
T1019 is personal care services (hands-on help with bathing, dressing, transfers). S5125 is attendant care, used by many waiver programs for similar help. S5130 is homemaker services (housekeeping, meals, errands). S5150 is unskilled respite, S5135 is adult companion care, and T2025 is a catch-all waiver service code. Each state picks which codes its programs use, and the authorization letter names the code.
The payer denies the units above the cap. The visit still happened and the caregiver still gets paid, so the overage is your cost. Several states also require EVV data to match the claim, so an over-cap visit cannot be fixed afterward by adjusting the clock-out time.
Usually not. Weekly and monthly authorizations reset; unused units are lost. A few waiver programs authorize a total for the plan year and let you flex week to week. Your authorization letter or the case manager will say which.
Divide by 4. 80 units is 20 hours; 26 units is 6.5 hours.
Related guides
Authorizations
How Do You Keep Caregiver Hours Inside a Medicaid Authorization?
Track units remaining, the end date and the service code for every client, and check them before each schedule change. Hours over the cap are unbillable.
Operations
Minimum Visit Length: Making Short Visits Profitable
One-hour home care visits lose money once paid travel and overhead are counted. Set a 2 to 4 hour minimum or a short-visit rate, and cluster Medicaid visits by route.
EVV
Why EVV Claims Get Denied and How to Fix Them
EVV claims are denied when the claim line does not match an accepted visit: client ID, date, provider, service code or units. How matching works, the seven causes, and a routine that keeps denials low.
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