CPT code 90951: ESRD monthly care, under 2 years, 4+ visits2026 Medicare rate & RVUs in Delaware

Monthly ESRD management for a patient younger than 2 years, reported when the physician or qualified professional provides at least four face-to-face visits.

CMS RVU26DEffective Oct 1, 2026One payment locality

In Delaware, Medicare pays $1,178.77 for 90951 in the office and $1,178.77 when it’s performed in a hospital or facility.

$1,178.77Office (non-facility)

$1,178.77Hospital or facility

−0.4%vs the national office rate ($1,183.73)

Check a contract rate as a % of Medicare · 90951 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

On this page 11 sections

Rate in Delaware
What 90951 covers
Compared with other areas
Rate map
How it’s calculated
Payment rules
Related codes
Rate history
Where it applies
Billing questions
Sources

What 90951 covers

CPT 90951 represents a month of ongoing end-stage renal disease management for a child younger than 2 years who receives at least four face-to-face visits from a physician or other qualified health care professional during that month. A nephrologist commonly provides this care in connection with dialysis, assessing matters such as the dialysis plan, fluid status, vascular access, laboratory findings, and related complications. The service is distinct from documenting a single dialysis treatment encounter.

Choose the monthly code using both the patient’s age category and the number of face-to-face visits in the month. The record should support the visits and the ESRD-related assessment and management provided; report the service for the month, not as one unit for each visit. For a patient receiving home dialysis, compare the home-dialysis monthly family, 90963–90966. When management covers only part of a month, compare the age-specific daily service family, 90967–90970.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Delaware compares for 90951

Across 109 of 109 payment localities, the office rate for 90951 runs from $1,112.70 in Arkansas to $1,583.15 in Alaska. Delaware pays $1,178.77. The RVUs are the same everywhere; the geographic indexes change the dollars.

90951 in Delaware vs other payment areas

Delaware · this page$1,178.77
Los Angeles, CA · California$1,261.59+$82.82
Washington, DC area · District of Columbia$1,292.19+$113.42
Miami, FL · Florida$1,272.07+$93.30
Chicago, IL · Illinois$1,254.15+$75.38
Manhattan, NY · New York$1,317.87+$139.10
Alaska · Alaska$1,583.15+$404.38

Other areas in Delaware first, then benchmark localities. Bars start at $0.

Every other payment area

90951 in every other Medicare payment locality
Payment locality	Office	Facility
AlabamaAlabama	$1,120.56	$1,120.56
ArkansasArkansas	$1,112.70	$1,112.70
ArizonaArizona	$1,166.29	$1,166.29
Bakersfield, CACalifornia	$1,212.10	$1,212.10
Chico, CACalifornia	$1,206.94	$1,206.94
El Centro, CACalifornia	$1,207.18	$1,207.18
Fresno, CACalifornia	$1,206.94	$1,206.94
Hanford, CACalifornia	$1,206.94	$1,206.94
Madera, CACalifornia	$1,206.94	$1,206.94
Merced, CACalifornia	$1,206.94	$1,206.94
Modesto, CACalifornia	$1,206.94	$1,206.94
Napa, CACalifornia	$1,316.92	$1,316.92
Oxnard, CACalifornia	$1,248.87	$1,248.87
Redding, CACalifornia	$1,206.94	$1,206.94
Rest of CaliforniaCalifornia	$1,206.94	$1,206.94
Riverside, CACalifornia	$1,223.20	$1,223.20
Sacramento, CACalifornia	$1,244.63	$1,244.63
Salinas, CACalifornia	$1,239.29	$1,239.29
San Diego, CACalifornia	$1,251.22	$1,251.22
Marin County, CACalifornia	$1,371.01	$1,371.01
San Francisco, CACalifornia	$1,369.35	$1,369.35
San Benito County, CACalifornia	$1,397.50	$1,397.50
Santa Clara County, CACalifornia	$1,390.72	$1,390.72
San Luis Obispo, CACalifornia	$1,221.39	$1,221.39
Santa Cruz, CACalifornia	$1,250.12	$1,250.12
Santa Maria, CACalifornia	$1,239.25	$1,239.25
Santa Rosa, CACalifornia	$1,261.68	$1,261.68
Stockton, CACalifornia	$1,206.94	$1,206.94
Vallejo, CACalifornia	$1,314.53	$1,314.53
Visalia, CACalifornia	$1,206.94	$1,206.94
Yuba City, CACalifornia	$1,206.94	$1,206.94
ColoradoColorado	$1,204.14	$1,204.14
ConnecticutConnecticut	$1,235.82	$1,235.82
Fort Lauderdale, FLFlorida	$1,227.50	$1,227.50
Rest of FloridaFlorida	$1,193.47	$1,193.47
Atlanta, GAGeorgia	$1,201.30	$1,201.30
Rest of GeorgiaGeorgia	$1,156.80	$1,156.80
Hawaii, Guam, HIHawaii	$1,209.23	$1,209.23
IowaIowa	$1,125.76	$1,125.76
IdahoIdaho	$1,131.15	$1,131.15
East St. Louis, ILIllinois	$1,206.29	$1,206.29
Rest of IllinoisIllinois	$1,181.95	$1,181.95
Suburban Chicago, ILIllinois	$1,236.04	$1,236.04
IndianaIndiana	$1,134.13	$1,134.13
KansasKansas	$1,127.28	$1,127.28
KentuckyKentucky	$1,142.29	$1,142.29
New Orleans, LALouisiana	$1,170.54	$1,170.54
Rest of LouisianaLouisiana	$1,143.04	$1,143.04
Metropolitan Boston, MAMassachusetts	$1,276.31	$1,276.31
Rest of MassachusettsMassachusetts	$1,204.42	$1,204.42
Baltimore area, MDMaryland	$1,232.60	$1,232.60
Rest of MarylandMaryland	$1,191.75	$1,191.75
Rest of MaineMaine	$1,138.41	$1,138.41
Southern Maine, MEMaine	$1,162.71	$1,162.71
Detroit, MIMichigan	$1,205.42	$1,205.42
Rest of MichiganMichigan	$1,160.79	$1,160.79
MinnesotaMinnesota	$1,159.14	$1,159.14
Metropolitan Kansas City, MOMissouri	$1,162.11	$1,162.11
Metropolitan St. Louis, MOMissouri	$1,167.70	$1,167.70
Rest of MissouriMissouri	$1,136.09	$1,136.09
MississippiMississippi	$1,124.29	$1,124.29
MontanaMontana	$1,183.63	$1,183.63
North CarolinaNorth Carolina	$1,143.61	$1,143.61
North DakotaNorth Dakota	$1,154.76	$1,154.76
NebraskaNebraska	$1,127.52	$1,127.52
New HampshireNew Hampshire	$1,191.41	$1,191.41
Northern New JerseyNew Jersey	$1,291.14	$1,291.14
Rest of New JerseyNew Jersey	$1,251.33	$1,251.33
New MexicoNew Mexico	$1,165.64	$1,165.64
NevadaNevada	$1,175.92	$1,175.92
NYC suburbs and Long Island, NYNew York	$1,340.16	$1,340.16
Poughkeepsie and northern NYC suburbs, NYNew York	$1,261.84	$1,261.84
Queens, NYNew York	$1,317.57	$1,317.57
Rest of New YorkNew York	$1,152.44	$1,152.44
OhioOhio	$1,154.88	$1,154.88
OklahomaOklahoma	$1,136.90	$1,136.90
Portland, OROregon	$1,221.32	$1,221.32
Rest of OregonOregon	$1,167.90	$1,167.90
Metropolitan Philadelphia, PAPennsylvania	$1,221.30	$1,221.30
Rest of PennsylvaniaPennsylvania	$1,153.49	$1,153.49
Puerto RicoPuerto Rico	$1,186.69	$1,186.69
Rhode IslandRhode Island	$1,204.73	$1,204.73
South CarolinaSouth Carolina	$1,150.88	$1,150.88
South DakotaSouth Dakota	$1,151.35	$1,151.35
TennesseeTennessee	$1,130.57	$1,130.57
Austin, TXTexas	$1,199.26	$1,199.26
Beaumont, TXTexas	$1,150.02	$1,150.02
Brazoria, TXTexas	$1,176.37	$1,176.37
Dallas, TXTexas	$1,182.65	$1,182.65
Fort Worth, TXTexas	$1,179.92	$1,179.92
Galveston, TXTexas	$1,179.38	$1,179.38
Houston, TXTexas	$1,206.10	$1,206.10
Rest of TexasTexas	$1,161.86	$1,161.86
UtahUtah	$1,158.59	$1,158.59
VirginiaVirginia	$1,163.68	$1,163.68
Virgin Islands, VIUnited States Virgin Islands	$1,186.69	$1,186.69
VermontVermont	$1,156.28	$1,156.28
Rest of WashingtonWashington	$1,200.27	$1,200.27
King County, WAWashington	$1,291.03	$1,291.03
WisconsinWisconsin	$1,135.87	$1,135.87
West VirginiaWest Virginia	$1,160.73	$1,160.73
WyomingWyoming	$1,171.05	$1,171.05

90951 rates by state

Office rate range in each state. Select a state to see its payment localities.

ME WI VT NH MT ND MN MI NY MA RI WA ID WY SD IA IL IN OH PA NJ CT OR NV UT CO NE MO KY WV VA MD DE CA AZ NM KS OK AR TN NC SC DC TX LA MS AL GA FL AK HI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$1,112.70

$1,583.15

Color shows the midpoint of each state’s locality range.

View every state and territory as a table

90951 office rate range by state
State / territory	Office rate range	Localities
AK	$1,583.15	1
AL	$1,120.56	1
AR	$1,112.70	1
AZ	$1,166.29	1
CA	$1,206.94–$1,397.50	29
CO	$1,204.14	1
CT	$1,235.82	1
DC	$1,292.19	1
DE	$1,178.77	1
FL	$1,193.47–$1,272.07	3
GA	$1,156.80–$1,201.30	2
GU	$1,209.23	1
HI	$1,209.23	1
IA	$1,125.76	1
ID	$1,131.15	1
IL	$1,181.95–$1,254.15	4
IN	$1,134.13	1
KS	$1,127.28	1
KY	$1,142.29	1
LA	$1,143.04–$1,170.54	2
MA	$1,204.42–$1,276.31	2
MD	$1,191.75–$1,292.19	3
ME	$1,138.41–$1,162.71	2
MI	$1,160.79–$1,205.42	2
MN	$1,159.14	1
MO	$1,136.09–$1,167.70	3
MS	$1,124.29	1
MT	$1,183.63	1
NC	$1,143.61	1
ND	$1,154.76	1
NE	$1,127.52	1
NH	$1,191.41	1
NJ	$1,251.33–$1,291.14	2
NM	$1,165.64	1
NV	$1,175.92	1
NY	$1,152.44–$1,340.16	5
OH	$1,154.88	1
OK	$1,136.90	1
OR	$1,167.90–$1,221.32	2
PA	$1,153.49–$1,221.30	2
PR	$1,186.69	1
RI	$1,204.73	1
SC	$1,150.88	1
SD	$1,151.35	1
TN	$1,130.57	1
TX	$1,150.02–$1,206.10	8
UT	$1,158.59	1
VA	$1,163.68–$1,292.19	2
VI	$1,186.69	1
VT	$1,156.28	1
WA	$1,200.27–$1,291.03	2
WI	$1,135.87	1
WV	$1,160.73	1
WY	$1,171.05	1

See 90951 in every payment locality

How the 90951 rate is calculated

Each of 90951’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 90951

RVUs × geographic indexes × conversion factor

Office or facility?

Your ZIP

Work23.92

23.92 RVUs× 1.000 GPCI

Practice expense10.06

10.06 RVUs× 1.000 GPCI

Malpractice1.46

1.46 RVUs× 1.000 GPCI

Adjusted RVUs

35.4400

Conversion factor

$33.4009

Medicare rate

$1,183.73

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Delaware inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,564

Code: 90951
Physician work: 23.92
Practice expense: 10.06
Malpractice: 1.46

GPCI2026.csv

Locality: Delaware
Physician work: 1.005
Practice expense: 0.988
Malpractice: 0.899

Office calculation for 90951 in Delaware
Component	RVU	Locality factor	Adjusted
Physician work	23.92	× 1.005	24.0396
Practice expense	10.06	× 0.988	9.9393
Malpractice	1.46	× 0.899	1.3125
Total RVUs			35.2914
Conversion factor			× 33.4009

Office rate, Delaware$1178.77

Office: (23.92 × 1.005 + 10.06 × 0.988 + 1.46 × 0.899) × $33.4009 = $1178.77

Facility: (23.92 × 1.005 + 10.06 × 0.988 + 1.46 × 0.899) × $33.4009 = $1178.77

Open 90951 in the RVU calculator

Payment rules and modifiers for 90951

90951 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

Place of service · 90951

Which rate does Medicare pay?

Place of service

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

$1,183.73

Non-facility (office): $1,183.73
Facility: $1,183.73

Higher because the practice carries its own overhead.

Codes related to 90951

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 90951
Code	How it relates	Office range, Delaware
Same family
90952	ESRD monthly services, 2-3 visits, under age 2For patients younger than 2 years with two or three face-to-face visits in the month.	No office rate
90953	Monthly ESRD services, one visit, under age 2For patients younger than 2 years with one face-to-face visit in the month.	No office rate
90954	ESRD management, age 2–11, four visitsUses the four-or-more-visit level for patients ages 2 through 11.	$1,029.96
Used instead
90963	ESRD management, home dialysis, under age 2Monthly ESRD-related service code for a patient younger than 2 years receiving home dialysis.	$623.39
90967	ESRD services, patient younger than 2Age-specific daily ESRD service code for patients younger than 2 years when management is reported by day.	$18.29

How 90951 has changed in Delaware

90951 · Office / nonfacility

$1178.77

Effective 2026-10-01

Compare with release effective

The base rate is $57.66 higher than on 2025-10-01, moving from $1121.11 to $1178.77 (5.1%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

January 1, 2026
RVU26A
$1121.11changed to$1178.77
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 9.04 changed to 10.06
- Malpractice RVU 1.64 changed to 1.46
- Work GPCI 1.009 changed to 1.005
- Practice expense GPCI 0.992 changed to 0.988
- Malpractice GPCI 0.949 changed to 0.899
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$1158.35changed to$1121.11
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 9.18 changed to 9.04
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$1139.44changed to$1158.35
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$1177.65changed to$1139.44
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 9.10 changed to 9.18
- Malpractice RVU 1.60 changed to 1.64
- Work GPCI 1.007 changed to 1.009
- Practice expense GPCI 1.007 changed to 0.992
- Malpractice GPCI 0.938 changed to 0.949
January 1, 2023
RVU23A
$1208.98changed to$1177.65
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 9.21 changed to 9.10
- Work GPCI 1.005 changed to 1.007
- Practice expense GPCI 1.022 changed to 1.007
- Malpractice GPCI 0.927 changed to 0.938
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$1205.62changed to$1208.98
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 8.88 changed to 9.21
- Malpractice RVU 1.55 changed to 1.60
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$970.23changed to$1205.62
- Conversion factor 36.0896 changed to 34.8931
- Work RVU 18.46 changed to 23.92
- Practice expense RVU 6.96 changed to 8.88
- Malpractice RVU 1.18 changed to 1.55
- Work GPCI 1.006 changed to 1.005
- Practice expense GPCI 1.021 changed to 1.022
- Malpractice GPCI 1.023 changed to 0.927
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$974.23changed to$970.23
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 6.99 changed to 6.96
- Work GPCI 1.007 changed to 1.006
- Practice expense GPCI 1.019 changed to 1.021
- Malpractice GPCI 1.119 changed to 1.023
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$975.32changed to$974.23
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 7.06 changed to 6.99
- Malpractice RVU 1.17 changed to 1.18
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$972.84changed to$975.32
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 7.01 changed to 7.06
- Malpractice RVU 1.16 changed to 1.17
- Work GPCI 1.010 changed to 1.007
- Practice expense GPCI 1.025 changed to 1.019
- Malpractice GPCI 1.101 changed to 1.119
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$972.93changed to$972.84
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 6.85 changed to 7.01
- Malpractice RVU 1.32 changed to 1.16
- Work GPCI 1.012 changed to 1.010
- Practice expense GPCI 1.031 changed to 1.025
- Malpractice GPCI 1.083 changed to 1.101
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$971.97changed to$972.93
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 6.95 changed to 6.85
- Malpractice RVU 1.11 changed to 1.32
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$967.13changed to$971.97
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$955.87changed to$967.13
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 6.88 changed to 6.95
- Malpractice RVU 0.98 changed to 1.11
- Practice expense GPCI 1.038 changed to 1.031
- Malpractice GPCI 0.878 changed to 1.083
Held through RVU15B.
January 1, 2014
RVU14A
$921.41changed to$955.87
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 7.39 changed to 6.88
- Malpractice RVU 1.02 changed to 0.98
- Practice expense GPCI 1.044 changed to 1.038
- Malpractice GPCI 0.672 changed to 0.878
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $921.41
Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective from	Office	Facility	CMS release
2026-10-01	$1,178.77	$1,178.77	RVU26D
2026-07-01	$1,178.77	$1,178.77	RVU26C
2026-04-01	$1,178.77	$1,178.77	RVU26B
2026-01-01	$1,178.77	$1,178.77	RVU26A
2025-10-01	$1,121.11	$1,121.11	RVU25D
2025-07-01	$1,121.11	$1,121.11	RVU25C
2025-04-01	$1,121.11	$1,121.11	RVU25B
2025-01-01	$1,121.11	$1,121.11	RVU25A
2024-10-01	$1,158.35	$1,158.35	RVU24D
2024-07-01	$1,158.35	$1,158.35	RVU24C
2024-04-01	$1,158.35	$1,158.35	RVU24B
2024-03-09	$1,158.35	$1,158.35	RVU24AR
2024-01-01	$1,139.44	$1,139.44	RVU24A
2023-10-01	$1,177.65	$1,177.65	RVU23D
2023-07-01	$1,177.65	$1,177.65	RVU23C
2023-04-01	$1,177.65	$1,177.65	RVU23B
2023-01-01	$1,177.65	$1,177.65	RVU23A
2022-10-01	$1,208.98	$1,208.98	RVU22D
2022-07-01	$1,208.98	$1,208.98	RVU22C
2022-04-01	$1,208.98	$1,208.98	RVU22B
2022-01-01	$1,208.98	$1,208.98	RVU22A
2021-10-01	$1,205.62	$1,205.62	RVU21D
2021-07-01	$1,205.62	$1,205.62	RVU21C
2021-04-01	$1,205.62	$1,205.62	RVU21B
2021-01-01	$1,205.62	$1,205.62	RVU21A
2020-10-01	$970.23	$970.23	RVU20D
2020-07-01	$970.23	$970.23	RVU20C
2020-04-01	$970.23	$970.23	RVU20B
2020-01-01	$970.23	$970.23	RVU20A
2019-10-01	$974.23	$974.23	RVU19D
2019-07-01	$974.23	$974.23	RVU19C
2019-04-01	$974.23	$974.23	RVU19B
2019-01-01	$974.23	$974.23	RVU19A
2018-10-01	$975.32	$975.32	RVU18D
2018-07-01	$975.32	$975.32	RVU18C
2018-04-01	$975.32	$975.32	RVU18B
2018-01-01	$975.32	$975.32	RVU18AR1
2017-10-01	$972.84	$972.84	RVU17D
2017-07-01	$972.84	$972.84	RVU17C
2017-04-01	$972.84	$972.84	RVU17B
2017-01-01	$972.84	$972.84	RVU17A
2016-10-01	$972.93	$972.93	RVU16D
2016-07-01	$972.93	$972.93	RVU16C
2016-04-01	$972.93	$972.93	RVU16B
2016-01-01	$972.93	$972.93	RVU16A
2015-10-01	$971.97	$971.60	RVU15D
2015-07-01	$971.97	$971.60	RVU15C
2015-04-01	$967.13	$966.76	RVU15B
2015-01-01	$967.13	$966.76	RVU15A
2014-10-01	$955.87	$955.87	RVU14D
2014-07-01	$955.87	$955.87	RVU14C
2014-04-01	$955.87	$955.87	RVU14B
2014-01-01	$955.87	$955.87	RVU14A
2013-10-01	$921.41	$921.41	RVU13D
2013-07-01	$921.41	$921.41	RVU13C
2013-04-01	$921.41	$921.41	RVU13B
2013-01-01	$921.41	$921.41	RVU13AR

Price 90951 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

Arden
Ardencroft
Ardentown
Bear
Bellefonte
Bethany Beach
Bethel
Blades

Browse all communities in Delaware

90951 billing questions

How many visits support 90951?

The patient must have at least four face-to-face visits with a physician or other qualified health care professional during the month. The record should support the visits and the ESRD-related management.

Is 90951 billed once for each visit?

No. It represents monthly ESRD-related management, selected by the monthly visit count rather than billed as a separate unit for each visit.

When should 90952 or 90953 be used instead?

For a patient younger than 2 years, 90952 is the sibling for two or three face-to-face visits in the month, and 90953 is for one visit.

Does 90951 describe home dialysis management?

For a patient receiving home dialysis, compare the age-based home-dialysis monthly codes 90963–90966 rather than choosing this code solely by visit count.

What documentation supports the monthly service?

Document the patient's age category, dates of face-to-face visits, and the ESRD-related assessment and management performed, such as review of dialysis needs, fluid status, access, or relevant laboratory findings.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate

RVUs for 90951PPRRVU2026_Oct_nonQPP.csv, line 11,564 (RVU26D)

11,56190940,,[CPT descriptor omitted],X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00

11,56290945,,[CPT descriptor omitted],A,,1.52,0.70,NA,0.70,,0.09,2.31,2.31,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

11,56390947,,[CPT descriptor omitted],A,,2.46,0.55,NA,0.55,,0.17,3.18,3.18,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

11,56490951,,[CPT descriptor omitted],A,,23.92,10.06,,10.06,,1.46,35.44,35.44,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

11,56590952,,[CPT descriptor omitted],C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

11,56690953,,[CPT descriptor omitted],C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

11,56790954,,[CPT descriptor omitted],A,,20.86,8.80,,8.80,,1.31,30.97,30.97,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

3704112,CO,01,COLORADO,1.012,1.064,0.781

3813102,CT,00,CONNECTICUT,1.020,1.077,1.210

3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113

4012102,DE,01,DELAWARE,1.005,0.988,0.899

4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808

4209102,FL,04,MIAMI,1.000,1.041,2.529

4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503

Open CMS source How we calculate rates

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What 90951 covers

How Delaware compares for 90951

Every other payment area

90951 rates by state

How the 90951 rate is calculated

Payment rules and modifiers for 90951

Codes related to 90951

How 90951 has changed in Delaware

Where the Delaware rate applies

90951 billing questions

How many visits support 90951?

Is 90951 billed once for each visit?

When should 90952 or 90953 be used instead?

Does 90951 describe home dialysis management?

What documentation supports the monthly service?

Where these rates come from

Did this answer your question about what 90951 pays in Delaware?

Put 90951 and the rest of your codes on one sheet