CPT code 90955: Monthly ESRD care, ages 2–11, 2–3 visits2026 Medicare rate & RVUs in Tennessee

In Tennessee, Medicare pays $512.84 for 90955 in the office and $512.84 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 90955 nationwide

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

What 90955 covers

CPT 90955 represents monthly end-stage renal disease (ESRD)-related care for a patient aged 2 through 11 when the physician or qualified health care professional conducts two or three face-to-face visits during the month. Pediatric nephrologists commonly report it while managing children receiving maintenance dialysis. Monthly care may involve reviewing the dialysis plan, volume and blood-pressure status, laboratory results, medications, vascular or peritoneal access concerns, and treatment complications. This is monthly management, not a code for an individual dialysis treatment.

Choose the code by the patient’s age and the number of qualifying face-to-face visits during the month. The record should support the visit dates and the renal management provided; count these visits, not dialysis sessions. Report the monthly service once for the applicable month, rather than assigning 90955 to each visit. CMS assigns work, practice-expense, and malpractice relative value units to the service.

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 Tennessee compares for 90955

Across 109 of 109 payment localities, the office rate for 90955 runs from $503.75 in Arkansas to $712.38 in Alaska. Tennessee pays $512.84. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

90955 rates by state

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

See 90955 in every payment locality

How the 90955 rate is calculated

Each of 90955’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.

Payment rules and modifiers for 90955

90955 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.

Codes related to 90955

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

How 90955 has changed in Tennessee

Price 90955 for an earlier date of service

Where the Tennessee rate applies

Tennessee is a Medicare payment area, not a city. Our Census mapping connects it to 504 cities and communities in Tennessee. Some span more than one payment area; confirm with the service ZIP.

• Adams
• Adamsville
• Alamo
• Alcoa
• Alexandria
• Algood
• Allardt
• Altamont

Browse all communities in Tennessee

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

Open CMS sourceHow we calculate rates