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Home Care Rates by State: Private Pay and Medicaid
Non-medical home care cost a median $35 an hour in 2025. What drives state differences, what Medicaid pays for personal care in four states, and how to price your agency.
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Non-medical in-home care in South Dakota cost a median of $44 an hour in 2025, according to the CareScout Cost of Care Survey, against $35 nationally.
| Measure | South Dakota | United States |
|---|---|---|
| Median hourly cost, non-medical in-home care | $44 | $35 |
| Caregiver wage, mean hourly (BLS) | $18.88 | — |
CareScout's 2025 survey reports homemaker and home health aide services together as non-medical in-home care. In South Dakota the median price is 2.3 times the average caregiver wage.
Personal Care Services, provider managed, per 15 minutes; Assistive Daily Living Services Waiver fee schedule, FY27 rate effective 2026-07-01. Self-directed S5125 is the same rate. Other waivers have their own fee schedules. Open the official rate source . Managed care plans may pay different rates.
Home health and personal care aides in South Dakota earned a median of $18.15 an hour in May 2025, according to the Bureau of Labor Statistics. The lowest-paid tenth earned under $15.62 and the highest-paid tenth over $22.75. See pay in South Dakota's largest metro areas.
South Dakota's minimum wage is $11.85 an hour. Adjusted annually by formula.
It is scheduled to rise to $12.30 on January 1, 2027 .
Overtime rules are on the South Dakota overtime and minimum wage page.
Enough to cover fully loaded caregiver labor, overhead and a margin. Starting from the South Dakota median aide wage of $18.15, with a 20% payroll burden, 5% paid time off and training, 5% unbilled travel, 5% overtime, 25% overhead and a 10% margin, the calculator below gives about $38.16 an hour. Change any number to match your agency.
Labor cost per billed hour is the pay rate, plus half the overtime share for time-and-a-half, plus payroll burden, divided by the share of paid hours you can bill. The bill rate is labor divided by one minus overhead and margin when overhead is a share of revenue, or labor plus overhead divided by one minus margin when it is dollars per hour. The bill rate to test starts at the South Dakota median price, so you can see the margin a typical rate leaves.
If you budget overhead as an annual figure, the bill rate calculator spreads it over your billable hours instead. Both are estimates for planning, not pricing or wage-and-hour advice.
Operations
Non-medical home care cost a median $35 an hour in 2025. What drives state differences, what Medicaid pays for personal care in four states, and how to price your agency.
Operations
Build your private-pay hourly rate from caregiver wage, payroll burden, unpaid-but-paid time, overhead and margin. Worked example and national benchmarks.
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Bill rate = loaded wage plus overhead, divided by one minus your margin. The formula, a quick table by wage, the payroll taxes behind it, and where shortcuts mislead.
Operations
Raise private-pay rates when costs rise, give at least 30 days' written notice (60 in Connecticut), explain the reason in one sentence. Sample letter included.
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