CPT code 90962: ESRD monthly care, one visit, age 20+2026 Medicare rate & RVUs in Idaho
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.
In Idaho, Medicare pays $204.15 for 90962 in the office and $204.15 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 Idaho 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. Idaho pays $204.15. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Idaho · this page$204.15
- Los Angeles, CA · California$233.72+$29.57
- Washington, DC area · District of Columbia$238.13+$33.98
- Miami, FL · Florida$229.97+$25.82
- Chicago, IL · Illinois$225.89+$21.74
- Manhattan, NY · New York$241.38+$37.23
- Alaska · Alaska$277.18+$73.03
Other areas in Idaho first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| Madera, CACalifornia | $222.22 | $222.22 |
| Merced, CACalifornia | $222.22 | $222.22 |
| Modesto, CACalifornia | $222.22 | $222.22 |
| Napa, CACalifornia | $247.15 | $247.15 |
| Oxnard, CACalifornia | $231.78 | $231.78 |
| Redding, CACalifornia | $222.22 | $222.22 |
| Rest of CaliforniaCalifornia | $222.22 | $222.22 |
| Riverside, CACalifornia | $224.67 | $224.67 |
| Sacramento, CACalifornia | $230.41 | $230.41 |
| Salinas, CACalifornia | $229.46 | $229.46 |
| San Diego, CACalifornia | $232.66 | $232.66 |
| Marin County, CACalifornia | $258.74 | $258.74 |
| San Francisco, CACalifornia | $258.49 | $258.49 |
| San Benito County, CACalifornia | $263.93 | $263.93 |
| Santa Clara County, CACalifornia | $262.91 | $262.91 |
| San Luis Obispo, CACalifornia | $226.02 | $226.02 |
| Santa Cruz, CACalifornia | $233.23 | $233.23 |
| Santa Maria, CACalifornia | $229.72 | $229.72 |
| Santa Rosa, CACalifornia | $235.45 | $235.45 |
| Stockton, CACalifornia | $222.22 | $222.22 |
| Vallejo, CACalifornia | $246.79 | $246.79 |
| Visalia, CACalifornia | $222.22 | $222.22 |
| Yuba City, CACalifornia | $222.22 | $222.22 |
| ColoradoColorado | $220.59 | $220.59 |
| ConnecticutConnecticut | $225.85 | $225.85 |
| DelawareDelaware | $213.89 | $213.89 |
| Fort Lauderdale, FLFlorida | $222.19 | $222.19 |
| Rest of FloridaFlorida | $214.90 | $214.90 |
| Atlanta, GAGeorgia | $218.35 | $218.35 |
| Rest of GeorgiaGeorgia | $206.95 | $206.95 |
| Hawaii, Guam, HIHawaii | $224.13 | $224.13 |
| IowaIowa | $203.15 | $203.15 |
| East St. Louis, ILIllinois | $215.47 | $215.47 |
| Rest of IllinoisIllinois | $211.54 | $211.54 |
| Suburban Chicago, ILIllinois | $224.00 | $224.00 |
| IndianaIndiana | $204.86 | $204.86 |
| KansasKansas | $202.96 | $202.96 |
| KentuckyKentucky | $204.65 | $204.65 |
| New Orleans, LALouisiana | $210.88 | $210.88 |
| Rest of LouisianaLouisiana | $204.61 | $204.61 |
| Metropolitan Boston, MAMassachusetts | $236.35 | $236.35 |
| Rest of MassachusettsMassachusetts | $220.21 | $220.21 |
| Baltimore area, MDMaryland | $225.21 | $225.21 |
| Rest of MarylandMaryland | $216.75 | $216.75 |
| Rest of MaineMaine | $205.24 | $205.24 |
| Southern Maine, MEMaine | $211.59 | $211.59 |
| Detroit, MIMichigan | $217.04 | $217.04 |
| Rest of MichiganMichigan | $208.35 | $208.35 |
| MinnesotaMinnesota | $212.50 | $212.50 |
| Metropolitan Kansas City, MOMissouri | $209.53 | $209.53 |
| Metropolitan St. Louis, MOMissouri | $210.87 | $210.87 |
| Rest of MissouriMissouri | $202.70 | $202.70 |
| MississippiMississippi | $200.88 | $200.88 |
| MontanaMontana | $215.09 | $215.09 |
| North CarolinaNorth Carolina | $206.52 | $206.52 |
| North DakotaNorth Dakota | $210.74 | $210.74 |
| NebraskaNebraska | $203.72 | $203.72 |
| New HampshireNew Hampshire | $217.81 | $217.81 |
| Northern New JerseyNew Jersey | $237.28 | $237.28 |
| Rest of New JerseyNew Jersey | $228.73 | $228.73 |
| New MexicoNew Mexico | $209.23 | $209.23 |
| NevadaNevada | $213.96 | $213.96 |
| NYC suburbs and Long Island, NYNew York | $245.76 | $245.76 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $230.42 | $230.42 |
| Queens, NYNew York | $242.09 | $242.09 |
| Rest of New YorkNew York | $208.49 | $208.49 |
| OhioOhio | $207.46 | $207.46 |
| OklahomaOklahoma | $203.99 | $203.99 |
| Portland, OROregon | $224.95 | $224.95 |
| Rest of OregonOregon | $212.57 | $212.57 |
| Metropolitan Philadelphia, PAPennsylvania | $222.30 | $222.30 |
| Rest of PennsylvaniaPennsylvania | $207.44 | $207.44 |
| Puerto RicoPuerto Rico | $215.97 | $215.97 |
| Rhode IslandRhode Island | $219.49 | $219.49 |
| South CarolinaSouth Carolina | $207.27 | $207.27 |
| South DakotaSouth Dakota | $210.22 | $210.22 |
| TennesseeTennessee | $203.64 | $203.64 |
| Austin, TXTexas | $219.64 | $219.64 |
| Beaumont, TXTexas | $206.61 | $206.61 |
| Brazoria, TXTexas | $213.64 | $213.64 |
| Dallas, TXTexas | $214.78 | $214.78 |
| Fort Worth, TXTexas | $213.99 | $213.99 |
| Galveston, TXTexas | $214.17 | $214.17 |
| Houston, TXTexas | $218.20 | $218.20 |
| Rest of TexasTexas | $209.87 | $209.87 |
| UtahUtah | $209.04 | $209.04 |
| VirginiaVirginia | $211.44 | $211.44 |
| Virgin Islands, VIUnited States Virgin Islands | $215.97 | $215.97 |
| VermontVermont | $210.59 | $210.59 |
| Rest of WashingtonWashington | $219.59 | $219.59 |
| King County, WAWashington | $239.81 | $239.81 |
| WisconsinWisconsin | $206.30 | $206.30 |
| West VirginiaWest Virginia | $206.67 | $206.67 |
| WyomingWyoming | $213.19 | $213.19 |
90962 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.
$199.06
$277.18
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 | $277.18 | 1 |
| AL | $200.85 | 1 |
| AR | $199.06 | 1 |
| AZ | $211.30 | 1 |
| CA | $222.22–$263.93 | 29 |
| CO | $220.59 | 1 |
| CT | $225.85 | 1 |
| DC | $238.13 | 1 |
| DE | $213.89 | 1 |
| FL | $214.90–$229.97 | 3 |
| GA | $206.95–$218.35 | 2 |
| GU | $224.13 | 1 |
| HI | $224.13 | 1 |
| IA | $203.15 | 1 |
| ID | $204.15 | 1 |
| IL | $211.54–$225.89 | 4 |
| IN | $204.86 | 1 |
| KS | $202.96 | 1 |
| KY | $204.65 | 1 |
| LA | $204.61–$210.88 | 2 |
| MA | $220.21–$236.35 | 2 |
| MD | $216.75–$238.13 | 3 |
| ME | $205.24–$211.59 | 2 |
| MI | $208.35–$217.04 | 2 |
| MN | $212.50 | 1 |
| MO | $202.70–$210.87 | 3 |
| MS | $200.88 | 1 |
| MT | $215.09 | 1 |
| NC | $206.52 | 1 |
| ND | $210.74 | 1 |
| NE | $203.72 | 1 |
| NH | $217.81 | 1 |
| NJ | $228.73–$237.28 | 2 |
| NM | $209.23 | 1 |
| NV | $213.96 | 1 |
| NY | $208.49–$245.76 | 5 |
| OH | $207.46 | 1 |
| OK | $203.99 | 1 |
| OR | $212.57–$224.95 | 2 |
| PA | $207.44–$222.30 | 2 |
| PR | $215.97 | 1 |
| RI | $219.49 | 1 |
| SC | $207.27 | 1 |
| SD | $210.22 | 1 |
| TN | $203.64 | 1 |
| TX | $206.61–$219.64 | 8 |
| UT | $209.04 | 1 |
| VA | $211.44–$238.13 | 2 |
| VI | $215.97 | 1 |
| VT | $210.59 | 1 |
| WA | $219.59–$239.81 | 2 |
| WI | $206.30 | 1 |
| WV | $206.67 | 1 |
| WY | $213.19 | 1 |
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
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 Idaho 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
47
- Locality
- Idaho
- Physician work
- 1.000
- Practice expense
- 0.920
- Malpractice
- 0.473
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.57 | × 1.000 | 3.5700 |
| Practice expense | 2.65 | × 0.920 | 2.4380 |
| Malpractice | 0.22 | × 0.473 | 0.1041 |
| Total RVUs | 6.1121 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Idaho$204.15
Office: (3.57 × 1 + 2.65 × 0.92 + 0.22 × 0.473) × $33.4009 = $204.15
Facility: (3.57 × 1 + 2.65 × 0.92 + 0.22 × 0.473) × $33.4009 = $204.15
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.
How 90962 has changed in Idaho
90962 · Office / nonfacility
$204.15
Effective 2026-10-01
The base rate is $17.99 higher than on 2025-10-01, moving from $186.16 to $204.15 (9.7%).
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
$186.16changed to$204.15
- 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
- Practice expense GPCI 0.908 changed to 0.920
- Malpractice GPCI 0.461 changed to 0.473
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$189.61changed to$186.16
- 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.
March 9, 2024
RVU24AR
$186.52changed to$189.61
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$189.92changed to$186.52
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 2.17 changed to 2.23
- Practice expense GPCI 0.893 changed to 0.908
- Malpractice GPCI 0.439 changed to 0.461
January 1, 2023
RVU23A
$192.27changed to$189.92
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 2.16 changed to 2.17
- Practice expense GPCI 0.877 changed to 0.893
- Malpractice GPCI 0.416 changed to 0.439
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$192.19changed to$192.27
- 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.
January 1, 2021
RVU21A
$177.57changed to$192.19
- 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
- Practice expense GPCI 0.890 changed to 0.877
- Malpractice GPCI 0.464 changed to 0.416
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$177.96changed to$177.57
- 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
- Practice expense GPCI 0.902 changed to 0.890
- Malpractice GPCI 0.512 changed to 0.464
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$177.76changed to$177.96
- Conversion factor 35.9996 changed to 36.0391
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$176.10changed to$177.76
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 1.85 changed to 1.88
- Practice expense GPCI 0.900 changed to 0.902
- Malpractice GPCI 0.510 changed to 0.512
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$176.18changed to$176.10
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 1.87 changed to 1.85
- Practice expense GPCI 0.898 changed to 0.900
- Malpractice GPCI 0.508 changed to 0.510
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$176.50changed to$176.18
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 1.86 changed to 1.87
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$175.62changed to$176.50
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$176.33changed to$175.62
- Conversion factor 35.8228 changed to 35.7547
- Malpractice RVU 0.19 changed to 0.18
- Practice expense GPCI 0.896 changed to 0.898
- Malpractice GPCI 0.556 changed to 0.508
Held through RVU15B.
January 1, 2014
RVU14A
$173.93changed to$176.33
- 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 0.894 changed to 0.896
- Malpractice GPCI 0.603 changed to 0.556
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $173.93
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $204.15 | $204.15 | RVU26D |
| 2026-07-01 | $204.15 | $204.15 | RVU26C |
| 2026-04-01 | $204.15 | $204.15 | RVU26B |
| 2026-01-01 | $204.15 | $204.15 | RVU26A |
| 2025-10-01 | $186.16 | $186.16 | RVU25D |
| 2025-07-01 | $186.16 | $186.16 | RVU25C |
| 2025-04-01 | $186.16 | $186.16 | RVU25B |
| 2025-01-01 | $186.16 | $186.16 | RVU25A |
| 2024-10-01 | $189.61 | $189.61 | RVU24D |
| 2024-07-01 | $189.61 | $189.61 | RVU24C |
| 2024-04-01 | $189.61 | $189.61 | RVU24B |
| 2024-03-09 | $189.61 | $189.61 | RVU24AR |
| 2024-01-01 | $186.52 | $186.52 | RVU24A |
| 2023-10-01 | $189.92 | $189.92 | RVU23D |
| 2023-07-01 | $189.92 | $189.92 | RVU23C |
| 2023-04-01 | $189.92 | $189.92 | RVU23B |
| 2023-01-01 | $189.92 | $189.92 | RVU23A |
| 2022-10-01 | $192.27 | $192.27 | RVU22D |
| 2022-07-01 | $192.27 | $192.27 | RVU22C |
| 2022-04-01 | $192.27 | $192.27 | RVU22B |
| 2022-01-01 | $192.27 | $192.27 | RVU22A |
| 2021-10-01 | $192.19 | $192.19 | RVU21D |
| 2021-07-01 | $192.19 | $192.19 | RVU21C |
| 2021-04-01 | $192.19 | $192.19 | RVU21B |
| 2021-01-01 | $192.19 | $192.19 | RVU21A |
| 2020-10-01 | $177.57 | $177.57 | RVU20D |
| 2020-07-01 | $177.57 | $177.57 | RVU20C |
| 2020-04-01 | $177.57 | $177.57 | RVU20B |
| 2020-01-01 | $177.57 | $177.57 | RVU20A |
| 2019-10-01 | $177.96 | $177.96 | RVU19D |
| 2019-07-01 | $177.96 | $177.96 | RVU19C |
| 2019-04-01 | $177.96 | $177.96 | RVU19B |
| 2019-01-01 | $177.96 | $177.96 | RVU19A |
| 2018-10-01 | $177.76 | $177.76 | RVU18D |
| 2018-07-01 | $177.76 | $177.76 | RVU18C |
| 2018-04-01 | $177.76 | $177.76 | RVU18B |
| 2018-01-01 | $177.76 | $177.76 | RVU18AR1 |
| 2017-10-01 | $176.10 | $176.10 | RVU17D |
| 2017-07-01 | $176.10 | $176.10 | RVU17C |
| 2017-04-01 | $176.10 | $176.10 | RVU17B |
| 2017-01-01 | $176.10 | $176.10 | RVU17A |
| 2016-10-01 | $176.18 | $176.18 | RVU16D |
| 2016-07-01 | $176.18 | $176.18 | RVU16C |
| 2016-04-01 | $176.18 | $176.18 | RVU16B |
| 2016-01-01 | $176.18 | $176.18 | RVU16A |
| 2015-10-01 | $176.50 | $176.50 | RVU15D |
| 2015-07-01 | $176.50 | $176.50 | RVU15C |
| 2015-04-01 | $175.62 | $175.62 | RVU15B |
| 2015-01-01 | $175.62 | $175.62 | RVU15A |
| 2014-10-01 | $176.33 | $176.33 | RVU14D |
| 2014-07-01 | $176.33 | $176.33 | RVU14C |
| 2014-04-01 | $176.33 | $176.33 | RVU14B |
| 2014-01-01 | $176.33 | $176.33 | RVU14A |
| 2013-10-01 | $173.93 | $173.93 | RVU13D |
| 2013-07-01 | $173.93 | $173.93 | RVU13C |
| 2013-04-01 | $173.93 | $173.93 | RVU13B |
| 2013-01-01 | $173.93 | $173.93 | RVU13AR |
Where the Idaho rate applies
Idaho is a Medicare payment area, not a city. Our Census mapping connects it to 235 cities and communities in Idaho. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Acequia
- Albion
- American Falls
- Ammon
- Arbon Valley
- Arco
- Arimo
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
Fee sheets · Coming soon
Put 90962 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist