CPT code 90959: ESRD monthly care, age 12–19, one visit2026 Medicare rate & RVUs in Houston, TX
Monthly ESRD-related management for a patient age 12 through 19 when one face-to-face visit is provided during the month.
In Houston, TX, Medicare pays $344.74 for 90959 in the office and $344.74 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 90959 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 90959 covers
Code 90959 represents monthly management of end-stage renal disease for a patient age 12 through 19, with one face-to-face visit during the month. A nephrologist or other qualified clinician typically evaluates the patient in connection with ongoing dialysis care, reviews the clinical course and relevant results, and manages issues such as fluid status, dialysis adequacy, anemia, mineral and bone disorders, and vascular access. The service may be furnished in a dialysis facility or another appropriate clinical setting.
Select this code using the patient’s age category and the number of face-to-face visits provided during the month. The record should support the monthly ESRD management, the date and substance of the face-to-face evaluation, and the patient’s age. Report the monthly service once for the applicable month rather than treating each dialysis treatment as a separate monthly service. Distinguish this facility-based monthly series from the separate monthly codes for patients receiving home dialysis.
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 Houston, TX compares for 90959
Across 109 of 109 payment localities, the office rate for 90959 runs from $315.89 in Arkansas to $444.30 in Alaska. Houston, TX pays $344.74. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Houston, TX · this page$344.74
- Austin, TX · Texas$344.86+$0.12
- Beaumont, TX · Texas$327.36−$17.38
- Brazoria, TX · Texas$336.73−$8.01
- Dallas, TX · Texas$338.55−$6.19
- Fort Worth, TX · Texas$337.53−$7.21
- Galveston, TX · Texas$337.60−$7.14
Other areas in Texas first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| Rest of TexasTexas | $331.67 | $331.67 |
| Los Angeles, CACalifornia | $364.94 | $364.94 |
| Washington, DC areaDistrict of Columbia | $372.88 | $372.88 |
| Miami, FLFlorida | $363.83 | $363.83 |
| Chicago, ILIllinois | $357.93 | $357.93 |
| Manhattan, NYNew York | $379.20 | $379.20 |
| AlaskaAlaska | $444.30 | $444.30 |
| AlabamaAlabama | $318.46 | $318.46 |
| ArkansasArkansas | $315.89 | $315.89 |
| ArizonaArizona | $333.45 | $333.45 |
| Bakersfield, CACalifornia | $349.30 | $349.30 |
| Chico, CACalifornia | $347.94 | $347.94 |
| El Centro, CACalifornia | $348.00 | $348.00 |
| Fresno, CACalifornia | $347.94 | $347.94 |
| Hanford, CACalifornia | $347.94 | $347.94 |
| Madera, CACalifornia | $347.94 | $347.94 |
| Merced, CACalifornia | $347.94 | $347.94 |
| Modesto, CACalifornia | $347.94 | $347.94 |
| Napa, CACalifornia | $383.55 | $383.55 |
| Oxnard, CACalifornia | $361.60 | $361.60 |
| Redding, CACalifornia | $347.94 | $347.94 |
| Rest of CaliforniaCalifornia | $347.94 | $347.94 |
| Riverside, CACalifornia | $352.27 | $352.27 |
| Sacramento, CACalifornia | $359.85 | $359.85 |
| Salinas, CACalifornia | $358.34 | $358.34 |
| San Diego, CACalifornia | $362.63 | $362.63 |
| Marin County, CACalifornia | $400.50 | $400.50 |
| San Francisco, CACalifornia | $400.06 | $400.06 |
| San Benito County, CACalifornia | $408.42 | $408.42 |
| Santa Clara County, CACalifornia | $406.61 | $406.61 |
| San Luis Obispo, CACalifornia | $353.06 | $353.06 |
| Santa Cruz, CACalifornia | $362.95 | $362.95 |
| Santa Maria, CACalifornia | $358.56 | $358.56 |
| Santa Rosa, CACalifornia | $366.36 | $366.36 |
| Stockton, CACalifornia | $347.94 | $347.94 |
| Vallejo, CACalifornia | $382.92 | $382.92 |
| Visalia, CACalifornia | $347.94 | $347.94 |
| Yuba City, CACalifornia | $347.94 | $347.94 |
| ColoradoColorado | $346.28 | $346.28 |
| ConnecticutConnecticut | $355.07 | $355.07 |
| DelawareDelaware | $337.31 | $337.31 |
| Fort Lauderdale, FLFlorida | $351.09 | $351.09 |
| Rest of FloridaFlorida | $340.32 | $340.32 |
| Atlanta, GAGeorgia | $344.17 | $344.17 |
| Rest of GeorgiaGeorgia | $328.64 | $328.64 |
| Hawaii, Guam, HIHawaii | $349.87 | $349.87 |
| IowaIowa | $321.03 | $321.03 |
| IdahoIdaho | $322.61 | $322.61 |
| East St. Louis, ILIllinois | $342.69 | $342.69 |
| Rest of IllinoisIllinois | $335.98 | $335.98 |
| Suburban Chicago, ILIllinois | $353.74 | $353.74 |
| IndianaIndiana | $323.62 | $323.62 |
| KansasKansas | $321.11 | $321.11 |
| KentuckyKentucky | $324.68 | $324.68 |
| New Orleans, LALouisiana | $333.76 | $333.76 |
| Rest of LouisianaLouisiana | $324.76 | $324.76 |
| Metropolitan Boston, MAMassachusetts | $369.20 | $369.20 |
| Rest of MassachusettsMassachusetts | $346.00 | $346.00 |
| Baltimore area, MDMaryland | $354.12 | $354.12 |
| Rest of MarylandMaryland | $341.45 | $341.45 |
| Rest of MaineMaine | $324.56 | $324.56 |
| Southern Maine, MEMaine | $333.14 | $333.14 |
| Detroit, MIMichigan | $343.78 | $343.78 |
| Rest of MichiganMichigan | $330.33 | $330.33 |
| MinnesotaMinnesota | $333.31 | $333.31 |
| Metropolitan Kansas City, MOMissouri | $331.45 | $331.45 |
| Metropolitan St. Louis, MOMissouri | $333.32 | $333.32 |
| Rest of MissouriMissouri | $322.23 | $322.23 |
| MississippiMississippi | $319.04 | $319.04 |
| MontanaMontana | $338.99 | $338.99 |
| North CarolinaNorth Carolina | $326.33 | $326.33 |
| North DakotaNorth Dakota | $331.28 | $331.28 |
| NebraskaNebraska | $321.74 | $321.74 |
| New HampshireNew Hampshire | $342.28 | $342.28 |
| Northern New JerseyNew Jersey | $372.01 | $372.01 |
| Rest of New JerseyNew Jersey | $359.52 | $359.52 |
| New MexicoNew Mexico | $331.74 | $331.74 |
| NevadaNevada | $336.96 | $336.96 |
| NYC suburbs and Long Island, NYNew York | $385.95 | $385.95 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $362.39 | $362.39 |
| Queens, NYNew York | $379.71 | $379.71 |
| Rest of New YorkNew York | $329.19 | $329.19 |
| OhioOhio | $328.75 | $328.75 |
| OklahomaOklahoma | $323.36 | $323.36 |
| Portland, OROregon | $352.23 | $352.23 |
| Rest of OregonOregon | $334.67 | $334.67 |
| Metropolitan Philadelphia, PAPennsylvania | $350.14 | $350.14 |
| Rest of PennsylvaniaPennsylvania | $328.52 | $328.52 |
| Puerto RicoPuerto Rico | $340.14 | $340.14 |
| Rhode IslandRhode Island | $345.48 | $345.48 |
| South CarolinaSouth Carolina | $328.00 | $328.00 |
| South DakotaSouth Dakota | $330.37 | $330.37 |
| TennesseeTennessee | $322.14 | $322.14 |
| UtahUtah | $330.54 | $330.54 |
| VirginiaVirginia | $333.16 | $333.16 |
| Virgin Islands, VIUnited States Virgin Islands | $340.14 | $340.14 |
| VermontVermont | $331.39 | $331.39 |
| Rest of WashingtonWashington | $344.91 | $344.91 |
| King County, WAWashington | $374.04 | $374.04 |
| WisconsinWisconsin | $325.00 | $325.00 |
| West VirginiaWest Virginia | $329.01 | $329.01 |
| WyomingWyoming | $335.63 | $335.63 |
90959 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.
$315.89
$444.30
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 | $444.30 | 1 |
| AL | $318.46 | 1 |
| AR | $315.89 | 1 |
| AZ | $333.45 | 1 |
| CA | $347.94–$408.42 | 29 |
| CO | $346.28 | 1 |
| CT | $355.07 | 1 |
| DC | $372.88 | 1 |
| DE | $337.31 | 1 |
| FL | $340.32–$363.83 | 3 |
| GA | $328.64–$344.17 | 2 |
| GU | $349.87 | 1 |
| HI | $349.87 | 1 |
| IA | $321.03 | 1 |
| ID | $322.61 | 1 |
| IL | $335.98–$357.93 | 4 |
| IN | $323.62 | 1 |
| KS | $321.11 | 1 |
| KY | $324.68 | 1 |
| LA | $324.76–$333.76 | 2 |
| MA | $346.00–$369.20 | 2 |
| MD | $341.45–$372.88 | 3 |
| ME | $324.56–$333.14 | 2 |
| MI | $330.33–$343.78 | 2 |
| MN | $333.31 | 1 |
| MO | $322.23–$333.32 | 3 |
| MS | $319.04 | 1 |
| MT | $338.99 | 1 |
| NC | $326.33 | 1 |
| ND | $331.28 | 1 |
| NE | $321.74 | 1 |
| NH | $342.28 | 1 |
| NJ | $359.52–$372.01 | 2 |
| NM | $331.74 | 1 |
| NV | $336.96 | 1 |
| NY | $329.19–$385.95 | 5 |
| OH | $328.75 | 1 |
| OK | $323.36 | 1 |
| OR | $334.67–$352.23 | 2 |
| PA | $328.52–$350.14 | 2 |
| PR | $340.14 | 1 |
| RI | $345.48 | 1 |
| SC | $328.00 | 1 |
| SD | $330.37 | 1 |
| TN | $322.14 | 1 |
| TX | $327.36–$344.86 | 8 |
| UT | $330.54 | 1 |
| VA | $333.16–$372.88 | 2 |
| VI | $340.14 | 1 |
| VT | $331.39 | 1 |
| WA | $344.91–$374.04 | 2 |
| WI | $325.00 | 1 |
| WV | $329.01 | 1 |
| WY | $335.63 | 1 |
How the 90959 rate is calculated
Each of 90959’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 · 90959
RVUs × geographic indexes × conversion factor
Work6.19
6.19 RVUs× 1.000 GPCI
Practice expense3.57
3.57 RVUs× 1.000 GPCI
Malpractice0.39
0.39 RVUs× 1.000 GPCI
Adjusted RVUs
10.1500
Conversion factor
$33.4009
Medicare rate
$339.02
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Houston, TX inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
11,572
- Code
- 90959
- Physician work
- 6.19
- Practice expense
- 3.57
- Malpractice
- 0.39
GPCI2026.csv
102
- Locality
- Houston, TX
- Physician work
- 1.008
- Practice expense
- 0.993
- Malpractice
- 1.376
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.19 | × 1.008 | 6.2395 |
| Practice expense | 3.57 | × 0.993 | 3.5450 |
| Malpractice | 0.39 | × 1.376 | 0.5366 |
| Total RVUs | 10.3212 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Houston, TX$344.74
Office: (6.19 × 1.008 + 3.57 × 0.993 + 0.39 × 1.376) × $33.4009 = $344.74
Facility: (6.19 × 1.008 + 3.57 × 0.993 + 0.39 × 1.376) × $33.4009 = $344.74
Payment rules and modifiers for 90959
90959 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 · 90959
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$339.02
- Non-facility (office)
- $339.02
- Facility
- $339.02
Higher because the practice carries its own overhead.
How 90959 has changed in Houston, TX
90959 · Office / nonfacility
$344.74
Effective 2026-10-01
The base rate is $21.74 higher than on 2025-10-01, moving from $323.00 to $344.74 (6.7%).
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
$323.00changed to$344.74
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 3.15 changed to 3.57
- Work GPCI 1.014 changed to 1.008
- Practice expense GPCI 1.003 changed to 0.993
- Malpractice GPCI 1.409 changed to 1.376
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$330.86changed to$323.00
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 3.09 changed to 3.15
- Malpractice RVU 0.40 changed to 0.39
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$325.46changed to$330.86
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$333.08changed to$325.46
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 3.01 changed to 3.09
- Malpractice RVU 0.38 changed to 0.40
- Work GPCI 1.023 changed to 1.014
- Practice expense GPCI 1.016 changed to 1.003
- Malpractice GPCI 1.154 changed to 1.409
January 1, 2023
RVU23A
$340.40changed to$333.08
- Conversion factor 34.6062 changed to 33.8872
- Malpractice RVU 0.39 changed to 0.38
- Work GPCI 1.032 changed to 1.023
- Practice expense GPCI 1.029 changed to 1.016
- Malpractice GPCI 0.900 changed to 1.154
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$340.04changed to$340.40
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 2.93 changed to 3.01
- Malpractice RVU 0.38 changed to 0.39
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$309.52changed to$340.04
- Conversion factor 36.0896 changed to 34.8931
- Work RVU 5.50 changed to 6.19
- Practice expense RVU 2.57 changed to 2.93
- Malpractice RVU 0.34 changed to 0.38
- Work GPCI 1.026 changed to 1.032
- Practice expense GPCI 1.020 changed to 1.029
- Malpractice GPCI 0.918 changed to 0.900
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$307.04changed to$309.52
- Conversion factor 36.0391 changed to 36.0896
- Malpractice RVU 0.33 changed to 0.34
- Work GPCI 1.020 changed to 1.026
- Practice expense GPCI 1.012 changed to 1.020
- Malpractice GPCI 0.936 changed to 0.918
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$306.01changed to$307.04
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 2.56 changed to 2.57
- Malpractice RVU 0.32 changed to 0.33
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$304.18changed to$306.01
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 2.54 changed to 2.56
- Practice expense GPCI 1.009 changed to 1.012
- Malpractice GPCI 0.946 changed to 0.936
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$303.46changed to$304.18
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 2.55 changed to 2.54
- Work GPCI 1.019 changed to 1.020
- Practice expense GPCI 1.006 changed to 1.009
- Malpractice GPCI 0.955 changed to 0.946
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$303.83changed to$303.46
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 2.53 changed to 2.55
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$302.32changed to$303.83
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$300.51changed to$302.32
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 2.52 changed to 2.53
- Malpractice RVU 0.30 changed to 0.32
- Work GPCI 1.014 changed to 1.019
- Practice expense GPCI 1.004 changed to 1.006
- Malpractice GPCI 0.939 changed to 0.955
Held through RVU15B.
January 1, 2014
RVU14A
$293.32changed to$300.51
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 2.78 changed to 2.52
- Malpractice RVU 0.31 changed to 0.30
- Work GPCI 1.009 changed to 1.014
- Practice expense GPCI 1.002 changed to 1.004
- Malpractice GPCI 0.923 changed to 0.939
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $293.32
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $344.74 | $344.74 | RVU26D |
| 2026-07-01 | $344.74 | $344.74 | RVU26C |
| 2026-04-01 | $344.74 | $344.74 | RVU26B |
| 2026-01-01 | $344.74 | $344.74 | RVU26A |
| 2025-10-01 | $323.00 | $323.00 | RVU25D |
| 2025-07-01 | $323.00 | $323.00 | RVU25C |
| 2025-04-01 | $323.00 | $323.00 | RVU25B |
| 2025-01-01 | $323.00 | $323.00 | RVU25A |
| 2024-10-01 | $330.86 | $330.86 | RVU24D |
| 2024-07-01 | $330.86 | $330.86 | RVU24C |
| 2024-04-01 | $330.86 | $330.86 | RVU24B |
| 2024-03-09 | $330.86 | $330.86 | RVU24AR |
| 2024-01-01 | $325.46 | $325.46 | RVU24A |
| 2023-10-01 | $333.08 | $333.08 | RVU23D |
| 2023-07-01 | $333.08 | $333.08 | RVU23C |
| 2023-04-01 | $333.08 | $333.08 | RVU23B |
| 2023-01-01 | $333.08 | $333.08 | RVU23A |
| 2022-10-01 | $340.40 | $340.40 | RVU22D |
| 2022-07-01 | $340.40 | $340.40 | RVU22C |
| 2022-04-01 | $340.40 | $340.40 | RVU22B |
| 2022-01-01 | $340.40 | $340.40 | RVU22A |
| 2021-10-01 | $340.04 | $340.04 | RVU21D |
| 2021-07-01 | $340.04 | $340.04 | RVU21C |
| 2021-04-01 | $340.04 | $340.04 | RVU21B |
| 2021-01-01 | $340.04 | $340.04 | RVU21A |
| 2020-10-01 | $309.52 | $309.52 | RVU20D |
| 2020-07-01 | $309.52 | $309.52 | RVU20C |
| 2020-04-01 | $309.52 | $309.52 | RVU20B |
| 2020-01-01 | $309.52 | $309.52 | RVU20A |
| 2019-10-01 | $307.04 | $307.04 | RVU19D |
| 2019-07-01 | $307.04 | $307.04 | RVU19C |
| 2019-04-01 | $307.04 | $307.04 | RVU19B |
| 2019-01-01 | $307.04 | $307.04 | RVU19A |
| 2018-10-01 | $306.01 | $306.01 | RVU18D |
| 2018-07-01 | $306.01 | $306.01 | RVU18C |
| 2018-04-01 | $306.01 | $306.01 | RVU18B |
| 2018-01-01 | $306.01 | $306.01 | RVU18AR1 |
| 2017-10-01 | $304.18 | $304.18 | RVU17D |
| 2017-07-01 | $304.18 | $304.18 | RVU17C |
| 2017-04-01 | $304.18 | $304.18 | RVU17B |
| 2017-01-01 | $304.18 | $304.18 | RVU17A |
| 2016-10-01 | $303.46 | $303.46 | RVU16D |
| 2016-07-01 | $303.46 | $303.46 | RVU16C |
| 2016-04-01 | $303.46 | $303.46 | RVU16B |
| 2016-01-01 | $303.46 | $303.46 | RVU16A |
| 2015-10-01 | $303.83 | $303.83 | RVU15D |
| 2015-07-01 | $303.83 | $303.83 | RVU15C |
| 2015-04-01 | $302.32 | $302.32 | RVU15B |
| 2015-01-01 | $302.32 | $302.32 | RVU15A |
| 2014-10-01 | $300.51 | $300.51 | RVU14D |
| 2014-07-01 | $300.51 | $300.51 | RVU14C |
| 2014-04-01 | $300.51 | $300.51 | RVU14B |
| 2014-01-01 | $300.51 | $300.51 | RVU14A |
| 2013-10-01 | $293.32 | $293.32 | RVU13D |
| 2013-07-01 | $293.32 | $293.32 | RVU13C |
| 2013-04-01 | $293.32 | $293.32 | RVU13B |
| 2013-01-01 | $293.32 | $293.32 | RVU13AR |
Where the Houston, TX rate applies
Houston, TX is a Medicare payment area, not a city. Our Census mapping connects it to 46 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.
- 90959 in Houston · multiple payment areas
- Aldine
- Atascocita
- Barrett
- 90959 in Baytown · multiple payment areas
- Bellaire
- Bunker Hill Village
- Channelview
90959 billing questions
When is 90959 chosen instead of 90958?
For a patient age 12 through 19, 90959 corresponds to one face-to-face visit during the month. Code 90958 is the sibling for two or three visits.
Does each dialysis treatment count as a visit for this code?
No. The code level is based on the number of face-to-face visits for monthly ESRD management, not the number of dialysis treatments performed.
Can 90959 be reported for each dialysis session?
No. It represents monthly ESRD-related management for the specified age and visit level, not a charge for each dialysis treatment.
What documentation supports reporting 90959?
Document the patient’s age, the date and substance of the face-to-face evaluation, and the ESRD-related management furnished during the month.
How does 90959 differ from the home dialysis monthly code?
90959 belongs to the monthly ESRD service series for the 12–19 age group and one face-to-face visit. Code 90965 is the corresponding monthly code for a home dialysis patient in that age group.
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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