CPT code 90960: Monthly ESRD services, age 20+, four or more visits2026 Medicare rate & RVUs in Miami, FL

Report monthly ESRD management for a facility-based dialysis patient age 20 or older when qualified practitioners furnish at least four face-to-face visits.

CMS RVU26DEffective Oct 1, 2026One payment locality1.1M Medicare services in 2024

In Miami, FL, Medicare pays $400.14 for 90960 in the office and $400.14 when it’s performed in a hospital or facility.

$400.14Office (non-facility)
$400.14Hospital or facility
+7.3%vs the national office rate ($372.75)

Check a contract rate as a % of Medicare · 90960 nationwide

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

We’ll open 90960 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Miami, FL
  2. What 90960 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 90960 covers

This service covers a full calendar month of professional ESRD management for a patient age 20 or older receiving facility-based dialysis, commonly in-center hemodialysis. A nephrologist or qualified nonphysician practitioner typically reviews dialysis adequacy, laboratory results, anemia treatment, bone-mineral management, fluid status, blood pressure, and vascular access concerns. Face-to-face visits commonly occur at the dialysis facility, with care coordinated with its staff.

Report one unit for the month when at least four qualifying face-to-face visits are documented; the visits do not generate four monthly units. Record each visit's date, practitioner, and ESRD-related assessment or management. Use 90961 or 90962 for a full month with fewer visits, and 90966 for monthly home dialysis management in this age group. For a partial month, such as dialysis initiation or a transplant during the month, consider the age-appropriate per-day ESRD code. Hospitalization alone does not make a month partial. The monthly professional service includes management of ESRD-related problems; dialysis facility services are distinct.

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 Miami, FL compares for 90960

Across 109 of 109 payment localities, the office rate for 90960 runs from $347.14 in Arkansas to $487.96 in Alaska. Miami, FL pays $400.14. The RVUs are the same everywhere; the geographic indexes change the dollars.

90960 in Miami, FL vs other payment areas
  1. Miami, FL · this page$400.14
  2. Fort Lauderdale, FL · Florida$386.08−$14.06
  3. Rest of Florida · Florida$374.16−$25.98
  4. Los Angeles, CA · California$401.40+$1.26
  5. Washington, DC area · District of Columbia$410.13+$9.99
  6. Chicago, IL · Illinois$393.60−$6.54
  7. Manhattan, NY · New York$417.07+$16.93

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

Every other payment area

90960 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$487.96$487.96
AlabamaAlabama$349.99$349.99
ArkansasArkansas$347.14$347.14
ArizonaArizona$366.59$366.59
Bakersfield, CACalifornia$384.13$384.13
Chico, CACalifornia$382.63$382.63
El Centro, CACalifornia$382.70$382.70
Fresno, CACalifornia$382.63$382.63

90960 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.

$347.14

$487.96

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

View every state and territory as a table
90960 office rate range by state
State / territoryOffice rate rangeLocalities
AK$487.961
AL$349.991
AR$347.141
AZ$366.591
CA$382.63–$449.4329
CO$380.791
CT$390.481
DC$410.131
DE$370.851
FL$374.16–$400.143
GA$361.23–$378.442
GU$384.831
HI$384.831
IA$352.851
ID$354.601
IL$369.33–$393.604
IN$355.721
KS$352.931
KY$356.851
LA$356.94–$366.902
MA$380.47–$406.112
MD$375.42–$410.133
ME$356.74–$366.262
MI$363.10–$377.982
MN$366.481
MO$354.13–$366.433
MS$350.621
MT$372.731
NC$358.711
ND$364.221
NE$353.641
NH$376.381
NJ$395.36–$409.142
NM$364.661
NV$370.491
NY$361.88–$424.535
OH$361.361
OK$355.401
OR$367.96–$387.382
PA$361.12–$385.022
PR$373.991
RI$379.861
SC$360.551
SD$363.221
TN$354.071
TX$359.83–$379.248
UT$363.351
VA$366.28–$410.132
VI$373.991
VT$364.341
WA$379.27–$411.462
WI$357.261
WV$361.621
WY$369.021

See 90960 in every payment locality

How the 90960 rate is calculated

Each of 90960’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 · 90960

RVUs × geographic indexes × conversion factor

Office or facility?

Work6.77

6.77 RVUs× 1.000 GPCI

Practice expense3.96

3.96 RVUs× 1.000 GPCI

Malpractice0.43

0.43 RVUs× 1.000 GPCI

Adjusted RVUs

11.1600

Conversion factor

$33.4009

Medicare rate

$372.75

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

The exact Miami, FL inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,573

Code
90960
Physician work
6.77
Practice expense
3.96
Malpractice
0.43

GPCI2026.csv

42

Locality
Miami, FL
Physician work
1.000
Practice expense
1.041
Malpractice
2.529
Office calculation for 90960 in Miami, FL
ComponentRVULocality factorAdjusted
Physician work6.77× 1.0006.7700
Practice expense3.96× 1.0414.1224
Malpractice0.43× 2.5291.0875
Total RVUs11.9798
Conversion factor× 33.4009

Office rate, Miami, FL$400.14

Office: (6.77 × 1 + 3.96 × 1.041 + 0.43 × 2.529) × $33.4009 = $400.14

Facility: (6.77 × 1 + 3.96 × 1.041 + 0.43 × 2.529) × $33.4009 = $400.14

Open 90960 in the RVU calculator

Payment rules and modifiers for 90960

90960 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 · 90960

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

$372.75

Non-facility (office)
$372.75
Facility
$372.75

Higher because the practice carries its own overhead.

How 90960 has changed in Miami, FL

90960 · Office / nonfacility

$400.14

Effective 2026-10-01

The base rate is $33.91 higher than on 2025-10-01, moving from $366.23 to $400.14 (9.3%).

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
  1. January 1, 2026

    RVU26A

    $366.23changed to$400.14

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 3.41 changed to 3.96
    • Malpractice RVU 0.42 changed to 0.43
    • Practice expense GPCI 1.027 changed to 1.041
    • Malpractice GPCI 2.500 changed to 2.529

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $372.97changed to$366.23

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.32 changed to 3.41
    • Malpractice RVU 0.41 changed to 0.42

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $366.89changed to$372.97

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $376.71changed to$366.89

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.24 changed to 3.32
    • Malpractice RVU 0.40 changed to 0.41
    • Practice expense GPCI 1.025 changed to 1.027
    • Malpractice GPCI 2.564 changed to 2.500
  5. January 1, 2023

    RVU23A

    $387.00changed to$376.71

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 3.26 changed to 3.24
    • Malpractice RVU 0.41 changed to 0.40
    • Practice expense GPCI 1.023 changed to 1.025
    • Malpractice GPCI 2.629 changed to 2.564

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $388.98changed to$387.00

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.20 changed to 3.26
    • Malpractice RVU 0.42 changed to 0.41

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $311.54changed to$388.98

    • Conversion factor 36.0896 changed to 34.8931
    • Work RVU 5.18 changed to 6.77
    • Practice expense RVU 2.58 changed to 3.20
    • Malpractice RVU 0.31 changed to 0.42
    • Practice expense GPCI 1.026 changed to 1.023
    • Malpractice GPCI 2.598 changed to 2.629

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $308.62changed to$311.54

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.54 changed to 2.58
    • Malpractice RVU 0.30 changed to 0.31
    • Practice expense GPCI 1.029 changed to 1.026
    • Malpractice GPCI 2.566 changed to 2.598

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $307.36changed to$308.62

    • Conversion factor 35.9996 changed to 36.0391
    • Malpractice RVU 0.29 changed to 0.30

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $306.36changed to$307.36

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.52 changed to 2.54
    • Malpractice RVU 0.30 changed to 0.29
    • Practice expense GPCI 1.031 changed to 1.029
    • Malpractice GPCI 2.528 changed to 2.566

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $306.16changed to$306.36

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.54 changed to 2.52
    • Practice expense GPCI 1.033 changed to 1.031
    • Malpractice GPCI 2.490 changed to 2.528

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $306.89changed to$306.16

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.53 changed to 2.54

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $305.36changed to$306.89

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $308.69changed to$305.36

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense GPCI 1.044 changed to 1.033
    • Malpractice GPCI 2.653 changed to 2.490

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $305.98changed to$308.69

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.79 changed to 2.53
    • Malpractice RVU 0.31 changed to 0.30
    • Practice expense GPCI 1.054 changed to 1.044
    • Malpractice GPCI 2.815 changed to 2.653

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $305.98

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$400.14$400.14RVU26D
2026-07-01$400.14$400.14RVU26C
2026-04-01$400.14$400.14RVU26B
2026-01-01$400.14$400.14RVU26A
2025-10-01$366.23$366.23RVU25D
2025-07-01$366.23$366.23RVU25C
2025-04-01$366.23$366.23RVU25B
2025-01-01$366.23$366.23RVU25A
2024-10-01$372.97$372.97RVU24D
2024-07-01$372.97$372.97RVU24C
2024-04-01$372.97$372.97RVU24B
2024-03-09$372.97$372.97RVU24AR
2024-01-01$366.89$366.89RVU24A
2023-10-01$376.71$376.71RVU23D
2023-07-01$376.71$376.71RVU23C
2023-04-01$376.71$376.71RVU23B
2023-01-01$376.71$376.71RVU23A
2022-10-01$387.00$387.00RVU22D
2022-07-01$387.00$387.00RVU22C
2022-04-01$387.00$387.00RVU22B
2022-01-01$387.00$387.00RVU22A
2021-10-01$388.98$388.98RVU21D
2021-07-01$388.98$388.98RVU21C
2021-04-01$388.98$388.98RVU21B
2021-01-01$388.98$388.98RVU21A
2020-10-01$311.54$311.54RVU20D
2020-07-01$311.54$311.54RVU20C
2020-04-01$311.54$311.54RVU20B
2020-01-01$311.54$311.54RVU20A
2019-10-01$308.62$308.62RVU19D
2019-07-01$308.62$308.62RVU19C
2019-04-01$308.62$308.62RVU19B
2019-01-01$308.62$308.62RVU19A
2018-10-01$307.36$307.36RVU18D
2018-07-01$307.36$307.36RVU18C
2018-04-01$307.36$307.36RVU18B
2018-01-01$307.36$307.36RVU18AR1
2017-10-01$306.36$306.36RVU17D
2017-07-01$306.36$306.36RVU17C
2017-04-01$306.36$306.36RVU17B
2017-01-01$306.36$306.36RVU17A
2016-10-01$306.16$306.16RVU16D
2016-07-01$306.16$306.16RVU16C
2016-04-01$306.16$306.16RVU16B
2016-01-01$306.16$306.16RVU16A
2015-10-01$306.89$306.89RVU15D
2015-07-01$306.89$306.89RVU15C
2015-04-01$305.36$305.36RVU15B
2015-01-01$305.36$305.36RVU15A
2014-10-01$308.69$308.69RVU14D
2014-07-01$308.69$308.69RVU14C
2014-04-01$308.69$308.69RVU14B
2014-01-01$308.69$308.69RVU14A
2013-10-01$305.98$305.98RVU13D
2013-07-01$305.98$305.98RVU13C
2013-04-01$305.98$305.98RVU13B
2013-01-01$305.98$305.98RVU13AR

Price 90960 for an earlier date of service

Where the Miami, FL rate applies

Miami, FL is a Medicare payment area, not a city. Our Census mapping connects it to 83 cities and communities in Florida. Some span more than one payment area; confirm with the service ZIP.

  • Miami
  • Aventura
  • Bal Harbour
  • Bay Harbor Islands
  • Big Coppitt Key
  • Big Pine Key
  • Biscayne Gardens
  • Biscayne Park

Browse all communities in Florida

90960 billing questions

How do I choose between 90960, 90961, and 90962?

Count qualifying face-to-face ESRD visits during the calendar month for a patient age 20 or older. Four or more supports 90960, two or three supports 90961, and one supports 90962.

How many units are reported when the patient has four or more visits?

Report one unit of 90960 for the full calendar month of professional ESRD management, rather than one unit for each visit.

Does 90960 describe each hemodialysis session?

No. It describes monthly professional management; 90935 describes a hemodialysis procedure with one evaluation when a procedure code is appropriate, such as during a hospital stay.

What should I report when the patient receives dialysis for only part of the month?

For partial-month management, such as dialysis beginning mid-month or ending after transplant or death, the age-appropriate per-day ESRD code is generally used; 90970 is the code for patients age 20 or older. Hospitalization during the month does not by itself require per-day billing.

Are office E/M visits for kidney-related problems separately billable during the month?

ESRD-related management is included in the monthly service. An office E/M service for an unrelated condition must be distinct from the dialysis management to be separately reported.

What documentation supports the four-visit threshold?

Identify the date and qualified practitioner for each face-to-face ESRD visit and document the assessment or management furnished. A laboratory review without a face-to-face visit does not add to the visit count.

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 90960PPRRVU2026_Oct_nonQPP.csv, line 11,573 (RVU26D)
Geographic factors for Miami, FLGPCI2026.csv, line 42 (RVU26D)

Open CMS sourceHow we calculate rates

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