S5126 Attendant care service /diem
Also known as: daily personal care, full-day attendant service
Personal attendant care services including assistance with activities of daily living, provided on a per diem (daily) basis covering full service day.
In Plain Language
Full-day care; 24-hour assistance
Clinical Context
Billed for comprehensive full-day personal assistance with activities of daily living for individuals requiring ongoing support.
RVU Information
CPT S5126 does not have a physician work RVU assigned by CMS. This is typical for supply, drug, and equipment codes — reimbursement is based on Average Sales Price (ASP), fee schedules, or payer contracts rather than the RVU system.
Billing & Documentation
S-codes are used by private payers (not Medicare) for services without a standard CPT or HCPCS code. Coverage varies significantly between insurers. Verify payer acceptance before billing and document medical necessity thoroughly.
Specialties
Frequently Asked Questions
What is CPT code S5126?
CPT S5126 (Attendant care service /diem) is a S Codes code. Personal attendant care services including assistance with activities of daily living, provided on a per diem (daily) basis covering full service day.
Is S5126 covered by insurance?
S5126 is a temporary HCPCS code. Coverage varies by payer and may change when permanent codes are assigned. Billed for comprehensive full-day personal assistance with activities of daily living for individuals requiring ongoing support.
When is CPT S5126 used?
Billed for comprehensive full-day personal assistance with activities of daily living for individuals requiring ongoing support.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.