CPT code 90958: ESRD management, age 12-19, 2-3 visits2026 Medicare rate & RVUs in Indiana
Monthly ESRD management for patients ages 12 through 19, reported when the physician or qualified professional provides two or three face-to-face visits.
In Indiana, Medicare pays $495.93 for 90958 in the office and $495.93 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 90958 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
What 90958 covers
This monthly service covers a physician’s or qualified health care professional’s management of a patient ages 12 through 19 receiving treatment for end-stage renal disease. A nephrologist commonly provides the visits in a dialysis facility, hospital, or office, addressing the patient’s dialysis plan and related clinical needs, such as treatment response, laboratory findings, medications, and dialysis-related complications. The code’s visit tier is based on two or three face-to-face visits during the month, not on the number of dialysis sessions the patient receives.
Report the monthly code when the patient’s age and documented face-to-face visit count match this tier. The record should identify the services and visit dates supporting ongoing ESRD management. It is one monthly service, not a separate unit for each encounter or dialysis treatment. CMS payment is based on the physician fee schedule values for this code.
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 Indiana compares for 90958
Across 109 of 109 payment localities, the office rate for 90958 runs from $485.05 in Arkansas to $685.37 in Alaska. Indiana pays $495.93. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Indiana · this page$495.93
- Los Angeles, CA · California$556.25+$60.32
- Washington, DC area · District of Columbia$568.84+$72.91
- Miami, FL · Florida$556.78+$60.85
- Chicago, IL · Illinois$548.25+$52.32
- Manhattan, NY · New York$579.08+$83.15
- Alaska · Alaska$685.37+$189.44
Other areas in Indiana first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $488.79 | $488.79 |
| ArkansasArkansas | $485.05 | $485.05 |
| ArizonaArizona | $510.55 | $510.55 |
| Bakersfield, CACalifornia | $533.21 | $533.21 |
| Chico, CACalifornia | $531.06 | $531.06 |
| El Centro, CACalifornia | $531.16 | $531.16 |
| Fresno, CACalifornia | $531.06 | $531.06 |
| Hanford, CACalifornia | $531.06 | $531.06 |
| Madera, CACalifornia | $531.06 | $531.06 |
| Merced, CACalifornia | $531.06 | $531.06 |
| Modesto, CACalifornia | $531.06 | $531.06 |
| Napa, CACalifornia | $583.10 | $583.10 |
| Oxnard, CACalifornia | $550.96 | $550.96 |
| Redding, CACalifornia | $531.06 | $531.06 |
| Rest of CaliforniaCalifornia | $531.06 | $531.06 |
| Riverside, CACalifornia | $537.85 | $537.85 |
| Sacramento, CACalifornia | $548.62 | $548.62 |
| Salinas, CACalifornia | $546.30 | $546.30 |
| San Diego, CACalifornia | $552.33 | $552.33 |
| Marin County, CACalifornia | $608.17 | $608.17 |
| San Francisco, CACalifornia | $607.48 | $607.48 |
| San Benito County, CACalifornia | $620.08 | $620.08 |
| Santa Clara County, CACalifornia | $617.25 | $617.25 |
| San Luis Obispo, CACalifornia | $538.31 | $538.31 |
| Santa Cruz, CACalifornia | $552.45 | $552.45 |
| Santa Maria, CACalifornia | $546.49 | $546.49 |
| Santa Rosa, CACalifornia | $557.61 | $557.61 |
| Stockton, CACalifornia | $531.06 | $531.06 |
| Vallejo, CACalifornia | $582.10 | $582.10 |
| Visalia, CACalifornia | $531.06 | $531.06 |
| Yuba City, CACalifornia | $531.06 | $531.06 |
| ColoradoColorado | $529.01 | $529.01 |
| ConnecticutConnecticut | $542.58 | $542.58 |
| DelawareDelaware | $516.28 | $516.28 |
| Fort Lauderdale, FLFlorida | $537.37 | $537.37 |
| Rest of FloridaFlorida | $521.54 | $521.54 |
| Atlanta, GAGeorgia | $526.50 | $526.50 |
| Rest of GeorgiaGeorgia | $504.41 | $504.41 |
| Hawaii, Guam, HIHawaii | $533.25 | $533.25 |
| IowaIowa | $492.09 | $492.09 |
| IdahoIdaho | $494.48 | $494.48 |
| East St. Louis, ILIllinois | $525.88 | $525.88 |
| Rest of IllinoisIllinois | $515.51 | $515.51 |
| Suburban Chicago, ILIllinois | $541.31 | $541.31 |
| KansasKansas | $492.42 | $492.42 |
| KentuckyKentucky | $498.26 | $498.26 |
| New Orleans, LALouisiana | $511.54 | $511.54 |
| Rest of LouisianaLouisiana | $498.46 | $498.46 |
| Metropolitan Boston, MAMassachusetts | $562.71 | $562.71 |
| Rest of MassachusettsMassachusetts | $528.79 | $528.79 |
| Baltimore area, MDMaryland | $541.13 | $541.13 |
| Rest of MarylandMaryland | $522.37 | $522.37 |
| Rest of MaineMaine | $497.52 | $497.52 |
| Southern Maine, MEMaine | $509.68 | $509.68 |
| Detroit, MIMichigan | $526.79 | $526.79 |
| Rest of MichiganMichigan | $506.67 | $506.67 |
| MinnesotaMinnesota | $509.26 | $509.26 |
| Metropolitan Kansas City, MOMissouri | $507.96 | $507.96 |
| Metropolitan St. Louis, MOMissouri | $510.66 | $510.66 |
| Rest of MissouriMissouri | $494.91 | $494.91 |
| MississippiMississippi | $489.95 | $489.95 |
| MontanaMontana | $518.68 | $518.68 |
| North CarolinaNorth Carolina | $500.06 | $500.06 |
| North DakotaNorth Dakota | $506.61 | $506.61 |
| NebraskaNebraska | $493.06 | $493.06 |
| New HampshireNew Hampshire | $523.08 | $523.08 |
| Northern New JerseyNew Jersey | $567.86 | $567.86 |
| Rest of New JerseyNew Jersey | $549.40 | $549.40 |
| New MexicoNew Mexico | $508.81 | $508.81 |
| NevadaNevada | $515.48 | $515.48 |
| NYC suburbs and Long Island, NYNew York | $589.16 | $589.16 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $553.85 | $553.85 |
| Queens, NYNew York | $579.52 | $579.52 |
| Rest of New YorkNew York | $504.23 | $504.23 |
| OhioOhio | $504.20 | $504.20 |
| OklahomaOklahoma | $496.12 | $496.12 |
| Portland, OROregon | $537.50 | $537.50 |
| Rest of OregonOregon | $511.99 | $511.99 |
| Metropolitan Philadelphia, PAPennsylvania | $535.50 | $535.50 |
| Rest of PennsylvaniaPennsylvania | $503.76 | $503.76 |
| Puerto RicoPuerto Rico | $520.27 | $520.27 |
| Rhode IslandRhode Island | $528.35 | $528.35 |
| South CarolinaSouth Carolina | $502.84 | $502.84 |
| South DakotaSouth Dakota | $505.19 | $505.19 |
| TennesseeTennessee | $493.93 | $493.93 |
| Austin, TXTexas | $526.84 | $526.84 |
| Beaumont, TXTexas | $502.09 | $502.09 |
| Brazoria, TXTexas | $515.35 | $515.35 |
| Dallas, TXTexas | $518.12 | $518.12 |
| Fort Worth, TXTexas | $516.69 | $516.69 |
| Galveston, TXTexas | $516.67 | $516.67 |
| Houston, TXTexas | $527.83 | $527.83 |
| Rest of TexasTexas | $508.14 | $508.14 |
| UtahUtah | $506.52 | $506.52 |
| VirginiaVirginia | $509.86 | $509.86 |
| Virgin Islands, VIUnited States Virgin Islands | $520.27 | $520.27 |
| VermontVermont | $506.96 | $506.96 |
| Rest of WashingtonWashington | $527.07 | $527.07 |
| King County, WAWashington | $569.76 | $569.76 |
| WisconsinWisconsin | $497.53 | $497.53 |
| West VirginiaWest Virginia | $505.40 | $505.40 |
| WyomingWyoming | $513.42 | $513.42 |
90958 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$485.05
$685.37
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $685.37 | 1 |
| AL | $488.79 | 1 |
| AR | $485.05 | 1 |
| AZ | $510.55 | 1 |
| CA | $531.06–$620.08 | 29 |
| CO | $529.01 | 1 |
| CT | $542.58 | 1 |
| DC | $568.84 | 1 |
| DE | $516.28 | 1 |
| FL | $521.54–$556.78 | 3 |
| GA | $504.41–$526.50 | 2 |
| GU | $533.25 | 1 |
| HI | $533.25 | 1 |
| IA | $492.09 | 1 |
| ID | $494.48 | 1 |
| IL | $515.51–$548.25 | 4 |
| IN | $495.93 | 1 |
| KS | $492.42 | 1 |
| KY | $498.26 | 1 |
| LA | $498.46–$511.54 | 2 |
| MA | $528.79–$562.71 | 2 |
| MD | $522.37–$568.84 | 3 |
| ME | $497.52–$509.68 | 2 |
| MI | $506.67–$526.79 | 2 |
| MN | $509.26 | 1 |
| MO | $494.91–$510.66 | 3 |
| MS | $489.95 | 1 |
| MT | $518.68 | 1 |
| NC | $500.06 | 1 |
| ND | $506.61 | 1 |
| NE | $493.06 | 1 |
| NH | $523.08 | 1 |
| NJ | $549.40–$567.86 | 2 |
| NM | $508.81 | 1 |
| NV | $515.48 | 1 |
| NY | $504.23–$589.16 | 5 |
| OH | $504.20 | 1 |
| OK | $496.12 | 1 |
| OR | $511.99–$537.50 | 2 |
| PA | $503.76–$535.50 | 2 |
| PR | $520.27 | 1 |
| RI | $528.35 | 1 |
| SC | $502.84 | 1 |
| SD | $505.19 | 1 |
| TN | $493.93 | 1 |
| TX | $502.09–$527.83 | 8 |
| UT | $506.52 | 1 |
| VA | $509.86–$568.84 | 2 |
| VI | $520.27 | 1 |
| VT | $506.96 | 1 |
| WA | $527.07–$569.76 | 2 |
| WI | $497.53 | 1 |
| WV | $505.40 | 1 |
| WY | $513.42 | 1 |
How the 90958 rate is calculated
Each of 90958’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 · 90958
RVUs × geographic indexes × conversion factor
Work9.87
9.87 RVUs× 1.000 GPCI
Practice expense5.05
5.05 RVUs× 1.000 GPCI
Malpractice0.61
0.61 RVUs× 1.000 GPCI
Adjusted RVUs
15.5300
Conversion factor
$33.4009
Medicare rate
$518.72
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Indiana inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
11,571
- Code
- 90958
- Physician work
- 9.87
- Practice expense
- 5.05
- Malpractice
- 0.61
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.87 | × 1.000 | 9.8700 |
| Practice expense | 5.05 | × 0.927 | 4.6814 |
| Malpractice | 0.61 | × 0.486 | 0.2965 |
| Total RVUs | 14.8478 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Indiana$495.93
Office: (9.87 × 1 + 5.05 × 0.927 + 0.61 × 0.486) × $33.4009 = $495.93
Facility: (9.87 × 1 + 5.05 × 0.927 + 0.61 × 0.486) × $33.4009 = $495.93
Payment rules and modifiers for 90958
90958 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 · 90958
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$518.72
- Non-facility (office)
- $518.72
- Facility
- $518.72
Higher because the practice carries its own overhead.
How 90958 has changed in Indiana
90958 · Office / nonfacility
$495.93
Effective 2026-10-01
The base rate is $35.56 higher than on 2025-10-01, moving from $460.37 to $495.93 (7.7%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
$460.37changed to$495.93
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 4.40 changed to 5.05
- Malpractice RVU 0.63 changed to 0.61
- Practice expense GPCI 0.922 changed to 0.927
- Malpractice GPCI 0.485 changed to 0.486
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$472.06changed to$460.37
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 4.35 changed to 4.40
- Malpractice RVU 0.62 changed to 0.63
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$464.36changed to$472.06
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$476.25changed to$464.36
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 4.28 changed to 4.35
- Malpractice RVU 0.60 changed to 0.62
- Practice expense GPCI 0.911 changed to 0.922
- Malpractice GPCI 0.475 changed to 0.485
January 1, 2023
RVU23A
$487.02changed to$476.25
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 4.35 changed to 4.28
- Malpractice RVU 0.62 changed to 0.60
- Practice expense GPCI 0.900 changed to 0.911
- Malpractice GPCI 0.465 changed to 0.475
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$487.29changed to$487.02
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 4.23 changed to 4.35
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$426.33changed to$487.29
- Conversion factor 36.0896 changed to 34.8931
- Work RVU 8.34 changed to 9.87
- Practice expense RVU 3.58 changed to 4.23
- Malpractice RVU 0.51 changed to 0.62
- Practice expense GPCI 0.910 changed to 0.900
- Malpractice GPCI 0.422 changed to 0.465
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$423.70changed to$426.33
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 3.52 changed to 3.58
- Malpractice RVU 0.48 changed to 0.51
- Practice expense GPCI 0.919 changed to 0.910
- Malpractice GPCI 0.379 changed to 0.422
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$423.05changed to$423.70
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 3.51 changed to 3.52
- Malpractice RVU 0.49 changed to 0.48
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$422.64changed to$423.05
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 3.47 changed to 3.51
- Practice expense GPCI 0.920 changed to 0.919
- Malpractice GPCI 0.498 changed to 0.379
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$424.52changed to$422.64
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 3.49 changed to 3.47
- Practice expense GPCI 0.921 changed to 0.920
- Malpractice GPCI 0.617 changed to 0.498
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$424.84changed to$424.52
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 3.46 changed to 3.49
- Malpractice RVU 0.48 changed to 0.49
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$422.72changed to$424.84
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$424.17changed to$422.72
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 3.49 changed to 3.46
- Malpractice RVU 0.46 changed to 0.48
- Practice expense GPCI 0.922 changed to 0.921
- Malpractice GPCI 0.615 changed to 0.617
Held through RVU15B.
January 1, 2014
RVU14A
$414.35changed to$424.17
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 3.84 changed to 3.49
- Malpractice RVU 0.48 changed to 0.46
- Practice expense GPCI 0.923 changed to 0.922
- Malpractice GPCI 0.613 changed to 0.615
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $414.35
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $495.93 | $495.93 | RVU26D |
| 2026-07-01 | $495.93 | $495.93 | RVU26C |
| 2026-04-01 | $495.93 | $495.93 | RVU26B |
| 2026-01-01 | $495.93 | $495.93 | RVU26A |
| 2025-10-01 | $460.37 | $460.37 | RVU25D |
| 2025-07-01 | $460.37 | $460.37 | RVU25C |
| 2025-04-01 | $460.37 | $460.37 | RVU25B |
| 2025-01-01 | $460.37 | $460.37 | RVU25A |
| 2024-10-01 | $472.06 | $472.06 | RVU24D |
| 2024-07-01 | $472.06 | $472.06 | RVU24C |
| 2024-04-01 | $472.06 | $472.06 | RVU24B |
| 2024-03-09 | $472.06 | $472.06 | RVU24AR |
| 2024-01-01 | $464.36 | $464.36 | RVU24A |
| 2023-10-01 | $476.25 | $476.25 | RVU23D |
| 2023-07-01 | $476.25 | $476.25 | RVU23C |
| 2023-04-01 | $476.25 | $476.25 | RVU23B |
| 2023-01-01 | $476.25 | $476.25 | RVU23A |
| 2022-10-01 | $487.02 | $487.02 | RVU22D |
| 2022-07-01 | $487.02 | $487.02 | RVU22C |
| 2022-04-01 | $487.02 | $487.02 | RVU22B |
| 2022-01-01 | $487.02 | $487.02 | RVU22A |
| 2021-10-01 | $487.29 | $487.29 | RVU21D |
| 2021-07-01 | $487.29 | $487.29 | RVU21C |
| 2021-04-01 | $487.29 | $487.29 | RVU21B |
| 2021-01-01 | $487.29 | $487.29 | RVU21A |
| 2020-10-01 | $426.33 | $426.33 | RVU20D |
| 2020-07-01 | $426.33 | $426.33 | RVU20C |
| 2020-04-01 | $426.33 | $426.33 | RVU20B |
| 2020-01-01 | $426.33 | $426.33 | RVU20A |
| 2019-10-01 | $423.70 | $423.70 | RVU19D |
| 2019-07-01 | $423.70 | $423.70 | RVU19C |
| 2019-04-01 | $423.70 | $423.70 | RVU19B |
| 2019-01-01 | $423.70 | $423.70 | RVU19A |
| 2018-10-01 | $423.05 | $423.05 | RVU18D |
| 2018-07-01 | $423.05 | $423.05 | RVU18C |
| 2018-04-01 | $423.05 | $423.05 | RVU18B |
| 2018-01-01 | $423.05 | $423.05 | RVU18AR1 |
| 2017-10-01 | $422.64 | $422.64 | RVU17D |
| 2017-07-01 | $422.64 | $422.64 | RVU17C |
| 2017-04-01 | $422.64 | $422.64 | RVU17B |
| 2017-01-01 | $422.64 | $422.64 | RVU17A |
| 2016-10-01 | $424.52 | $424.52 | RVU16D |
| 2016-07-01 | $424.52 | $424.52 | RVU16C |
| 2016-04-01 | $424.52 | $424.52 | RVU16B |
| 2016-01-01 | $424.52 | $424.52 | RVU16A |
| 2015-10-01 | $424.84 | $424.50 | RVU15D |
| 2015-07-01 | $424.84 | $424.50 | RVU15C |
| 2015-04-01 | $422.72 | $422.39 | RVU15B |
| 2015-01-01 | $422.72 | $422.39 | RVU15A |
| 2014-10-01 | $424.17 | $424.17 | RVU14D |
| 2014-07-01 | $424.17 | $424.17 | RVU14C |
| 2014-04-01 | $424.17 | $424.17 | RVU14B |
| 2014-01-01 | $424.17 | $424.17 | RVU14A |
| 2013-10-01 | $414.35 | $414.35 | RVU13D |
| 2013-07-01 | $414.35 | $414.35 | RVU13C |
| 2013-04-01 | $414.35 | $414.35 | RVU13B |
| 2013-01-01 | $414.35 | $414.35 | RVU13AR |
Where the Indiana rate applies
Indiana is a Medicare payment area, not a city. Our Census mapping connects it to 974 cities and communities in Indiana. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Abington
- Adams
- Adams Lake
- Advance
- Akron
- Alamo
- Albany
90958 billing questions
How does 90958 differ from 90957?
Both are monthly ESRD management codes for patients ages 12 through 19. Use 90958 for two or three face-to-face visits; 90957 is the four-visit tier.
Can 90958 be reported when there is only one face-to-face visit?
No. The one-visit monthly tier for a patient ages 12 through 19 is 90959.
Do dialysis sessions count as the face-to-face visits?
The tier is based on face-to-face visits for monthly ESRD management, not simply the number of dialysis treatments. Document the management encounters and their dates.
What code applies if ESRD services cover only part of the month?
90969 is the per-day ESRD services code for patients ages 12 through 19. It differs from 90958’s monthly visit-count tier.
Is 90958 reported once for each visit?
No. It represents the monthly service at the two-to-three-visit level, rather than a separate unit for each face-to-face encounter.
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
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