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CPT code 90962: ESRD monthly care, one visit, age 20+2026 Medicare rate & RVUs in Delaware

Monthly ESRD-related management for a patient age 20 or older receiving facility-based dialysis when the physician or qualified professional makes one visit that month.

CMS RVU26DEffective Oct 1, 2026One payment locality125.9K Medicare services in 2024

In Delaware, Medicare pays $213.89 for 90962 in the office and $213.89 when it’s performed in a hospital or facility.

$213.89Office (non-facility)
$213.89Hospital or facility
−0.6%vs the national office rate ($215.10)

Check a contract rate as a % of Medicare · 90962 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 90962 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Delaware
  2. What 90962 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 90962 covers

This code represents monthly management of end-stage renal disease for an adult receiving dialysis outside the home-dialysis monthly service series. A nephrologist or other qualified health care professional typically evaluates the patient and manages ESRD-related concerns such as dialysis adequacy, vascular access, fluid status, anemia, medication needs, and complications. Care may involve coordination with the dialysis facility and the patient’s broader treatment team.

Report one unit for the calendar month when the patient is age 20 or older and the service meets the one-visit level. Select the monthly code using the patient’s age, dialysis setting or modality, and number of qualifying visits during the month; this code is distinct from levels for two or three visits and four or more visits. Documentation should support the visit and the monthly ESRD management provided. It represents monthly care, not a separate charge for each dialysis session.

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 Delaware compares for 90962

Across 109 of 109 payment localities, the office rate for 90962 runs from $199.06 in Arkansas to $277.18 in Alaska. Delaware pays $213.89. The RVUs are the same everywhere; the geographic indexes change the dollars.

90962 in Delaware vs other payment areas
  1. Delaware · this page$213.89
  2. Los Angeles, CA · California$233.72+$19.83
  3. Washington, DC area · District of Columbia$238.13+$24.24
  4. Miami, FL · Florida$229.97+$16.08
  5. Chicago, IL · Illinois$225.89+$12.00
  6. Manhattan, NY · New York$241.38+$27.49
  7. Alaska · Alaska$277.18+$63.29

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

Every other payment area

90962 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$200.85$200.85
ArkansasArkansas$199.06$199.06
ArizonaArizona$211.30$211.30
Bakersfield, CACalifornia$222.99$222.99
Chico, CACalifornia$222.22$222.22
El Centro, CACalifornia$222.25$222.25
Fresno, CACalifornia$222.22$222.22
Hanford, CACalifornia$222.22$222.22

90962 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.

$199.06

$277.18

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

View every state and territory as a table
90962 office rate range by state
State / territoryOffice rate rangeLocalities
AK$277.181
AL$200.851
AR$199.061
AZ$211.301
CA$222.22–$263.9329
CO$220.591
CT$225.851
DC$238.131
DE$213.891
FL$214.90–$229.973
GA$206.95–$218.352
GU$224.131
HI$224.131
IA$203.151
ID$204.151
IL$211.54–$225.894
IN$204.861
KS$202.961
KY$204.651
LA$204.61–$210.882
MA$220.21–$236.352
MD$216.75–$238.133
ME$205.24–$211.592
MI$208.35–$217.042
MN$212.501
MO$202.70–$210.873
MS$200.881
MT$215.091
NC$206.521
ND$210.741
NE$203.721
NH$217.811
NJ$228.73–$237.282
NM$209.231
NV$213.961
NY$208.49–$245.765
OH$207.461
OK$203.991
OR$212.57–$224.952
PA$207.44–$222.302
PR$215.971
RI$219.491
SC$207.271
SD$210.221
TN$203.641
TX$206.61–$219.648
UT$209.041
VA$211.44–$238.132
VI$215.971
VT$210.591
WA$219.59–$239.812
WI$206.301
WV$206.671
WY$213.191

See 90962 in every payment locality

How the 90962 rate is calculated

Each of 90962’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 · 90962

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.57

3.57 RVUs× 1.000 GPCI

Practice expense2.65

2.65 RVUs× 1.000 GPCI

Malpractice0.22

0.22 RVUs× 1.000 GPCI

Adjusted RVUs

6.4400

Conversion factor

$33.4009

Medicare rate

$215.10

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

The exact Delaware inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,575

Code
90962
Physician work
3.57
Practice expense
2.65
Malpractice
0.22

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 90962 in Delaware
ComponentRVULocality factorAdjusted
Physician work3.57× 1.0053.5878
Practice expense2.65× 0.9882.6182
Malpractice0.22× 0.8990.1978
Total RVUs6.4038
Conversion factor× 33.4009

Office rate, Delaware$213.89

Office: (3.57 × 1.005 + 2.65 × 0.988 + 0.22 × 0.899) × $33.4009 = $213.89

Facility: (3.57 × 1.005 + 2.65 × 0.988 + 0.22 × 0.899) × $33.4009 = $213.89

Open 90962 in the RVU calculator

Payment rules and modifiers for 90962

90962 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 · 90962

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

$215.10

Non-facility (office)
$215.10
Facility
$215.10

Higher because the practice carries its own overhead.

Codes related to 90962

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

Codes related to 90962
CodeHow it relatesOffice range, Delaware
Same family
90960Monthly ESRD services, age 20+, four or more visitsMonthly ESRD care for patients age 20 or older with four or more visits.$370.85
90961ESRD management, 2-3 visits, age 20+Monthly ESRD care for patients age 20 or older with two or three visits.$308.97
Used instead
90966Home dialysis, monthly, age 20 and olderMonthly ESRD care for a patient age 20 or older receiving home dialysis.$308.64
90970ESRD services, per day, age 20 or olderPer-day ESRD services for a patient age 20 or older when care covers part of a month.$9.97

How 90962 has changed in Delaware

90962 · Office / nonfacility

$213.89

Effective 2026-10-01

The base rate is $17.13 higher than on 2025-10-01, moving from $196.76 to $213.89 (8.7%).

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

    $196.76changed to$213.89

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 2.30 changed to 2.65
    • Malpractice RVU 0.21 changed to 0.22
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $200.49changed to$196.76

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.23 changed to 2.30
    • Malpractice RVU 0.22 changed to 0.21

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $197.22changed to$200.49

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $202.87changed to$197.22

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.17 changed to 2.23
    • Work GPCI 1.007 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.992
    • Malpractice GPCI 0.938 changed to 0.949

  5. January 1, 2023

    RVU23A

    $207.61changed to$202.87

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.16 changed to 2.17
    • Work GPCI 1.005 changed to 1.007
    • Practice expense GPCI 1.022 changed to 1.007
    • Malpractice GPCI 0.927 changed to 0.938

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $207.23changed to$207.61

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.11 changed to 2.16
    • Malpractice RVU 0.21 changed to 0.22

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $191.02changed to$207.23

    • Conversion factor 36.0896 changed to 34.8931
    • Work RVU 3.15 changed to 3.57
    • Practice expense RVU 1.89 changed to 2.11
    • Malpractice RVU 0.19 changed to 0.21
    • Work GPCI 1.006 changed to 1.005
    • Practice expense GPCI 1.021 changed to 1.022
    • Malpractice GPCI 1.023 changed to 0.927

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $190.62changed to$191.02

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.88 changed to 1.89
    • Malpractice RVU 0.18 changed to 0.19
    • Work GPCI 1.007 changed to 1.006
    • Practice expense GPCI 1.019 changed to 1.021
    • Malpractice GPCI 1.119 changed to 1.023

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $190.41changed to$190.62

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $189.35changed to$190.41

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.85 changed to 1.88
    • Work GPCI 1.010 changed to 1.007
    • Practice expense GPCI 1.025 changed to 1.019
    • Malpractice GPCI 1.101 changed to 1.119

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $190.15changed to$189.35

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.87 changed to 1.85
    • Work GPCI 1.012 changed to 1.010
    • Practice expense GPCI 1.031 changed to 1.025
    • Malpractice GPCI 1.083 changed to 1.101

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $190.46changed to$190.15

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.86 changed to 1.87

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $189.51changed to$190.46

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $189.33changed to$189.51

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.19 changed to 0.18
    • Practice expense GPCI 1.038 changed to 1.031
    • Malpractice GPCI 0.878 changed to 1.083

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $186.20changed to$189.33

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.06 changed to 1.86
    • Malpractice RVU 0.20 changed to 0.19
    • Practice expense GPCI 1.044 changed to 1.038
    • Malpractice GPCI 0.672 changed to 0.878

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $186.20

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$213.89$213.89RVU26D
2026-07-01$213.89$213.89RVU26C
2026-04-01$213.89$213.89RVU26B
2026-01-01$213.89$213.89RVU26A
2025-10-01$196.76$196.76RVU25D
2025-07-01$196.76$196.76RVU25C
2025-04-01$196.76$196.76RVU25B
2025-01-01$196.76$196.76RVU25A
2024-10-01$200.49$200.49RVU24D
2024-07-01$200.49$200.49RVU24C
2024-04-01$200.49$200.49RVU24B
2024-03-09$200.49$200.49RVU24AR
2024-01-01$197.22$197.22RVU24A
2023-10-01$202.87$202.87RVU23D
2023-07-01$202.87$202.87RVU23C
2023-04-01$202.87$202.87RVU23B
2023-01-01$202.87$202.87RVU23A
2022-10-01$207.61$207.61RVU22D
2022-07-01$207.61$207.61RVU22C
2022-04-01$207.61$207.61RVU22B
2022-01-01$207.61$207.61RVU22A
2021-10-01$207.23$207.23RVU21D
2021-07-01$207.23$207.23RVU21C
2021-04-01$207.23$207.23RVU21B
2021-01-01$207.23$207.23RVU21A
2020-10-01$191.02$191.02RVU20D
2020-07-01$191.02$191.02RVU20C
2020-04-01$191.02$191.02RVU20B
2020-01-01$191.02$191.02RVU20A
2019-10-01$190.62$190.62RVU19D
2019-07-01$190.62$190.62RVU19C
2019-04-01$190.62$190.62RVU19B
2019-01-01$190.62$190.62RVU19A
2018-10-01$190.41$190.41RVU18D
2018-07-01$190.41$190.41RVU18C
2018-04-01$190.41$190.41RVU18B
2018-01-01$190.41$190.41RVU18AR1
2017-10-01$189.35$189.35RVU17D
2017-07-01$189.35$189.35RVU17C
2017-04-01$189.35$189.35RVU17B
2017-01-01$189.35$189.35RVU17A
2016-10-01$190.15$190.15RVU16D
2016-07-01$190.15$190.15RVU16C
2016-04-01$190.15$190.15RVU16B
2016-01-01$190.15$190.15RVU16A
2015-10-01$190.46$190.46RVU15D
2015-07-01$190.46$190.46RVU15C
2015-04-01$189.51$189.51RVU15B
2015-01-01$189.51$189.51RVU15A
2014-10-01$189.33$189.33RVU14D
2014-07-01$189.33$189.33RVU14C
2014-04-01$189.33$189.33RVU14B
2014-01-01$189.33$189.33RVU14A
2013-10-01$186.20$186.20RVU13D
2013-07-01$186.20$186.20RVU13C
2013-04-01$186.20$186.20RVU13B
2013-01-01$186.20$186.20RVU13AR

Price 90962 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

  • Arden
  • Ardencroft
  • Ardentown
  • Bear
  • Bellefonte
  • Bethany Beach
  • Bethel
  • Blades

Browse all communities in Delaware

90962 billing questions

When is 90962 selected instead of 90961 or 90960?

Use 90962 for an eligible patient age 20 or older when there is one qualifying visit in the month. The other codes in this group correspond to two or three visits, or four or more visits.

Does 90962 represent each dialysis treatment?

No. It represents the monthly ESRD-related management level, not a per-session service. Do not count each dialysis treatment as a separate unit of 90962.

Can 90962 be used for a patient receiving home dialysis?

The home-dialysis monthly series has separate codes, including 90966 for patients age 20 or older. Choose the code that matches the patient’s dialysis setting and monthly circumstances.

What documentation supports the one-visit level?

Document the date and substance of the qualifying visit, the patient’s ESRD-related assessment and management, and the care coordination performed. The record should also support the patient’s age and dialysis circumstances.

What if monthly ESRD care covers only part of the month?

The per-day ESRD service series may be relevant when care is provided for only part of a month. For a patient age 20 or older, compare the circumstances with 90970.

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 90962PPRRVU2026_Oct_nonQPP.csv, line 11,575 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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