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

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 Kentucky, Medicare pays $356.85 for 90960 in the office and $356.85 when it’s performed in a hospital or facility.

$356.85Office (non-facility)
$356.85Hospital or facility
−4.3%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 Kentucky
  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 Kentucky 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. Kentucky pays $356.85. The RVUs are the same everywhere; the geographic indexes change the dollars.

90960 in Kentucky vs other payment areas
  1. Kentucky · this page$356.85
  2. Los Angeles, CA · California$401.40+$44.55
  3. Washington, DC area · District of Columbia$410.13+$53.28
  4. Miami, FL · Florida$400.14+$43.29
  5. Chicago, IL · Illinois$393.60+$36.75
  6. Manhattan, NY · New York$417.07+$60.22
  7. Alaska · Alaska$487.96+$131.11

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

Every other payment area

90960 in every other Medicare payment locality
Payment localityOfficeFacility
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
Hanford, CACalifornia$382.63$382.63

90960 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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 Kentucky 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

55

Locality
Kentucky
Physician work
1.000
Practice expense
0.889
Malpractice
0.915
Office calculation for 90960 in Kentucky
ComponentRVULocality factorAdjusted
Physician work6.77× 1.0006.7700
Practice expense3.96× 0.8893.5204
Malpractice0.43× 0.9150.3935
Total RVUs10.6839
Conversion factor× 33.4009

Office rate, Kentucky$356.85

Office: (6.77 × 1 + 3.96 × 0.889 + 0.43 × 0.915) × $33.4009 = $356.85

Facility: (6.77 × 1 + 3.96 × 0.889 + 0.43 × 0.915) × $33.4009 = $356.85

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.

Codes related to 90960

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

Codes related to 90960
CodeHow it relatesOffice range, Kentucky
Same family
90961ESRD management, 2-3 visits, age 20+Adult monthly ESRD service when two or three qualifying visits occur.$296.93
90962ESRD monthly care, one visit, age 20+Adult monthly ESRD service with one qualifying visit.$204.65
90957ESRD monthly care, age 12–19, four or more visitsFour-plus-visit monthly ESRD service for patients age 12 through 19.$766.65
Used instead
90966Home dialysis, monthly, age 20 and olderMonthly ESRD management for patients age 20 or older on home dialysis.$296.63
90970ESRD services, per day, age 20 or olderPer-day ESRD management for patients age 20 or older during a partial month.$9.58
90935Hemodialysis, one clinician evaluationHemodialysis procedure with one evaluation when procedure-based rather than monthly management coding is appropriate.No office rate

How 90960 has changed in Kentucky

90960 · Office / nonfacility

$356.85

Effective 2026-10-01

The base rate is $28.73 higher than on 2025-10-01, moving from $328.12 to $356.85 (8.8%).

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

    $328.12changed to$356.85

    • 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 0.877 changed to 0.889
    • Malpractice GPCI 0.913 changed to 0.915

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $334.74changed to$328.12

    • 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

    $329.27changed to$334.74

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $337.06changed to$329.27

    • 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 0.873 changed to 0.877
    • Malpractice GPCI 0.870 changed to 0.913

  5. January 1, 2023

    RVU23A

    $344.06changed to$337.06

    • 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 0.869 changed to 0.873
    • Malpractice GPCI 0.827 changed to 0.870

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $345.38changed to$344.06

    • 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

    $277.53changed to$345.38

    • 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 0.874 changed to 0.869
    • Malpractice GPCI 0.823 changed to 0.827

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $276.09changed to$277.53

    • 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 0.880 changed to 0.874
    • Malpractice GPCI 0.819 changed to 0.823

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $275.49changed to$276.09

    • 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

    $273.82changed to$275.49

    • 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 0.876 changed to 0.880
    • Malpractice GPCI 0.807 changed to 0.819

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $273.31changed to$273.82

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.54 changed to 2.52
    • Practice expense GPCI 0.872 changed to 0.876
    • Malpractice GPCI 0.795 changed to 0.807

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $273.98changed to$273.31

    • 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

    $272.62changed to$273.98

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $272.91changed to$272.62

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice GPCI 0.774 changed to 0.795

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $266.85changed to$272.91

    • 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 0.871 changed to 0.872
    • Malpractice GPCI 0.752 changed to 0.774

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $266.85

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$356.85$356.85RVU26D
2026-07-01$356.85$356.85RVU26C
2026-04-01$356.85$356.85RVU26B
2026-01-01$356.85$356.85RVU26A
2025-10-01$328.12$328.12RVU25D
2025-07-01$328.12$328.12RVU25C
2025-04-01$328.12$328.12RVU25B
2025-01-01$328.12$328.12RVU25A
2024-10-01$334.74$334.74RVU24D
2024-07-01$334.74$334.74RVU24C
2024-04-01$334.74$334.74RVU24B
2024-03-09$334.74$334.74RVU24AR
2024-01-01$329.27$329.27RVU24A
2023-10-01$337.06$337.06RVU23D
2023-07-01$337.06$337.06RVU23C
2023-04-01$337.06$337.06RVU23B
2023-01-01$337.06$337.06RVU23A
2022-10-01$344.06$344.06RVU22D
2022-07-01$344.06$344.06RVU22C
2022-04-01$344.06$344.06RVU22B
2022-01-01$344.06$344.06RVU22A
2021-10-01$345.38$345.38RVU21D
2021-07-01$345.38$345.38RVU21C
2021-04-01$345.38$345.38RVU21B
2021-01-01$345.38$345.38RVU21A
2020-10-01$277.53$277.53RVU20D
2020-07-01$277.53$277.53RVU20C
2020-04-01$277.53$277.53RVU20B
2020-01-01$277.53$277.53RVU20A
2019-10-01$276.09$276.09RVU19D
2019-07-01$276.09$276.09RVU19C
2019-04-01$276.09$276.09RVU19B
2019-01-01$276.09$276.09RVU19A
2018-10-01$275.49$275.49RVU18D
2018-07-01$275.49$275.49RVU18C
2018-04-01$275.49$275.49RVU18B
2018-01-01$275.49$275.49RVU18AR1
2017-10-01$273.82$273.82RVU17D
2017-07-01$273.82$273.82RVU17C
2017-04-01$273.82$273.82RVU17B
2017-01-01$273.82$273.82RVU17A
2016-10-01$273.31$273.31RVU16D
2016-07-01$273.31$273.31RVU16C
2016-04-01$273.31$273.31RVU16B
2016-01-01$273.31$273.31RVU16A
2015-10-01$273.98$273.98RVU15D
2015-07-01$273.98$273.98RVU15C
2015-04-01$272.62$272.62RVU15B
2015-01-01$272.62$272.62RVU15A
2014-10-01$272.91$272.91RVU14D
2014-07-01$272.91$272.91RVU14C
2014-04-01$272.91$272.91RVU14B
2014-01-01$272.91$272.91RVU14A
2013-10-01$266.85$266.85RVU13D
2013-07-01$266.85$266.85RVU13C
2013-04-01$266.85$266.85RVU13B
2013-01-01$266.85$266.85RVU13AR

Price 90960 for an earlier date of service

Where the Kentucky rate applies

Kentucky is a Medicare payment area, not a city. Our Census mapping connects it to 553 cities and communities in Kentucky. Some span more than one payment area; confirm with the service ZIP.

  • Adairville
  • Ages
  • Albany
  • Alexandria
  • Allen
  • Allensville
  • Anchorage
  • Annville

Browse all communities in Kentucky

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 KentuckyGPCI2026.csv, line 55 (RVU26D)

Open CMS sourceHow we calculate rates

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