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CPT code 90965: Home dialysis, ages 12 through 192026 Medicare rate & RVUs in Washington, DC area

Monthly ESRD-related physician services for a home dialysis patient ages 12 through 19, covering ongoing clinical management rather than individual dialysis sessions.

CMS RVU26DEffective Oct 1, 2026One payment locality716 Medicare services in 2024

In Washington, DC area, Medicare pays $566.01 for 90965 in the office and $566.01 when it’s performed in a hospital or facility.

$566.01Office (non-facility)
$566.01Hospital or facility
+9.7%vs the national office rate ($516.04)

Check a contract rate as a % of Medicare · 90965 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 90965 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 90965 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 90965 covers

This code represents a month of ESRD-related physician or qualified health care professional services for a patient ages 12 through 19 who receives dialysis at home. Care may include managing the dialysis prescription, reviewing treatment adequacy and relevant laboratory results, assessing fluid status and complications, and coordinating the patient’s renal care. The service is reported for the patient’s monthly home-dialysis management, not for each dialysis treatment or each contact during the month.

Select this code when the patient’s age and home-dialysis status match the code’s criteria and the practitioner provides the corresponding monthly ESRD-related services. Documentation should support the patient’s age, home treatment status, and clinical management during the month. Report the age-specific sibling for a different age group; when services cover only part of a month, use the applicable per-day code rather than this monthly code.

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 Washington, DC area compares for 90965

Across 109 of 109 payment localities, the office rate for 90965 runs from $482.54 in Arkansas to $681.67 in Alaska. Washington, DC area pays $566.01. The RVUs are the same everywhere; the geographic indexes change the dollars.

90965 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$566.01
  2. Los Angeles, CA · California$553.60−$12.41
  3. Miami, FL · Florida$553.60−$12.41
  4. Chicago, IL · Illinois$545.13−$20.88
  5. Manhattan, NY · New York$576.06+$10.05
  6. Alaska · Alaska$681.67+$115.66
  7. Alabama · Alabama$486.26−$79.75

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

90965 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$482.54$482.54
ArizonaArizona$507.93$507.93
Bakersfield, CACalifornia$530.62$530.62
Chico, CACalifornia$528.50$528.50
El Centro, CACalifornia$528.60$528.60
Fresno, CACalifornia$528.50$528.50
Hanford, CACalifornia$528.50$528.50
Madera, CACalifornia$528.50$528.50

90965 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.

$482.54

$681.67

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

View every state and territory as a table
90965 office rate range by state
State / territoryOffice rate rangeLocalities
AK$681.671
AL$486.261
AR$482.541
AZ$507.931
CA$528.50–$617.3129
CO$526.381
CT$539.791
DC$566.011
DE$513.631
FL$518.70–$553.603
GA$501.67–$523.752
GU$530.721
HI$530.721
IA$489.621
ID$491.991
IL$512.65–$545.134
IN$493.431
KS$489.911
KY$495.621
LA$495.80–$508.822
MA$526.15–$559.982
MD$519.70–$566.013
ME$494.97–$507.132
MI$503.95–$523.892
MN$506.831
MO$492.25–$507.993
MS$487.371
MT$516.001
NC$497.511
ND$504.141
NE$490.591
NH$520.451
NJ$546.60–$565.022
NM$506.071
NV$512.871
NY$501.66–$586.055
OH$501.531
OK$493.531
OR$509.42–$534.872
PA$501.11–$532.722
PR$517.601
RI$525.671
SC$500.221
SD$502.741
TN$491.421
TX$499.44–$525.028
UT$503.881
VA$507.28–$566.012
VI$517.601
VT$504.461
WA$524.45–$567.032
WI$495.091
WV$502.591
WY$510.831

See 90965 in every payment locality

How the 90965 rate is calculated

Each of 90965’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 · 90965

RVUs × geographic indexes × conversion factor

Office or facility?

Work9.80

9.80 RVUs× 1.000 GPCI

Practice expense5.05

5.05 RVUs× 1.000 GPCI

Malpractice0.60

0.60 RVUs× 1.000 GPCI

Adjusted RVUs

15.4500

Conversion factor

$33.4009

Medicare rate

$516.04

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

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,578

Code
90965
Physician work
9.80
Practice expense
5.05
Malpractice
0.60

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 90965 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work9.80× 1.05410.3292
Practice expense5.05× 1.1785.9489
Malpractice0.60× 1.1130.6678
Total RVUs16.9459
Conversion factor× 33.4009

Office rate, Washington, DC area$566.01

Office: (9.8 × 1.054 + 5.05 × 1.178 + 0.6 × 1.113) × $33.4009 = $566.01

Facility: (9.8 × 1.054 + 5.05 × 1.178 + 0.6 × 1.113) × $33.4009 = $566.01

Open 90965 in the RVU calculator

Payment rules and modifiers for 90965

90965 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 · 90965

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

$516.04

Non-facility (office)
$516.04
Facility
$516.04

Higher because the practice carries its own overhead.

Codes related to 90965

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

Codes related to 90965
CodeHow it relatesOffice range, Washington, DC area
Same family
90964ESRD services, home dialysis, ages 2–11Monthly home-dialysis ESRD services for patients ages 2 through 11.$585.35
90966Home dialysis, monthly, age 20 and olderMonthly home-dialysis ESRD services for patients age 20 or older.$341.88
90963ESRD management, home dialysis, under age 2Monthly home-dialysis ESRD services for patients younger than 2.$686.04
Used instead
90969Daily ESRD care, ages 12-19Per-day home-dialysis ESRD services for patients ages 12 through 19 when care covers part of a month.$19.05
90957ESRD monthly care, age 12–19, four or more visitsAge 12-through-19 monthly ESRD services in the visit-count series, rather than the home-dialysis series.$872.64

How 90965 has changed in Washington, DC area

90965 · Office / nonfacility

$566.01

Effective 2026-10-01

The base rate is $35.95 higher than on 2025-10-01, moving from $530.06 to $566.01 (6.8%).

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

    $530.06changed to$566.01

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 4.44 changed to 5.05
    • Malpractice RVU 0.63 changed to 0.60
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $543.11changed to$530.06

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.39 changed to 4.44
    • Malpractice RVU 0.62 changed to 0.63

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $534.24changed to$543.11

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $553.02changed to$534.24

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.32 changed to 4.39
    • Malpractice RVU 0.59 changed to 0.62
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $571.28changed to$553.02

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.35 changed to 4.32
    • Malpractice RVU 0.62 changed to 0.59
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $572.14changed to$571.28

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.26 changed to 4.35

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $516.45changed to$572.14

    • Conversion factor 36.0896 changed to 34.8931
    • Work RVU 8.69 changed to 9.80
    • Practice expense RVU 3.70 changed to 4.26
    • Malpractice RVU 0.53 changed to 0.62
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $508.09changed to$516.45

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.63 changed to 3.70
    • Malpractice RVU 0.51 changed to 0.53
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $506.67changed to$508.09

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.61 changed to 3.63

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $505.81changed to$506.67

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.59 changed to 3.61
    • Malpractice RVU 0.52 changed to 0.51
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $505.29changed to$505.81

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.58 changed to 3.59
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $507.09changed to$505.29

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.59 changed to 3.58
    • Malpractice RVU 0.51 changed to 0.52

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $504.57changed to$507.09

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $500.87changed to$504.57

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.57 changed to 3.59
    • Malpractice RVU 0.47 changed to 0.51
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $488.36changed to$500.87

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.91 changed to 3.57
    • Malpractice RVU 0.49 changed to 0.47
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $488.36

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$566.01$566.01RVU26D
2026-07-01$566.01$566.01RVU26C
2026-04-01$566.01$566.01RVU26B
2026-01-01$566.01$566.01RVU26A
2025-10-01$530.06$530.06RVU25D
2025-07-01$530.06$530.06RVU25C
2025-04-01$530.06$530.06RVU25B
2025-01-01$530.06$530.06RVU25A
2024-10-01$543.11$543.11RVU24D
2024-07-01$543.11$543.11RVU24C
2024-04-01$543.11$543.11RVU24B
2024-03-09$543.11$543.11RVU24AR
2024-01-01$534.24$534.24RVU24A
2023-10-01$553.02$553.02RVU23D
2023-07-01$553.02$553.02RVU23C
2023-04-01$553.02$553.02RVU23B
2023-01-01$553.02$553.02RVU23A
2022-10-01$571.28$571.28RVU22D
2022-07-01$571.28$571.28RVU22C
2022-04-01$571.28$571.28RVU22B
2022-01-01$571.28$571.28RVU22A
2021-10-01$572.14$572.14RVU21D
2021-07-01$572.14$572.14RVU21C
2021-04-01$572.14$572.14RVU21B
2021-01-01$572.14$572.14RVU21A
2020-10-01$516.45$516.45RVU20D
2020-07-01$516.45$516.45RVU20C
2020-04-01$516.45$516.45RVU20B
2020-01-01$516.45$516.45RVU20A
2019-10-01$508.09$508.09RVU19D
2019-07-01$508.09$508.09RVU19C
2019-04-01$508.09$508.09RVU19B
2019-01-01$508.09$508.09RVU19A
2018-10-01$506.67$506.67RVU18D
2018-07-01$506.67$506.67RVU18C
2018-04-01$506.67$506.67RVU18B
2018-01-01$506.67$506.67RVU18AR1
2017-10-01$505.81$505.81RVU17D
2017-07-01$505.81$505.81RVU17C
2017-04-01$505.81$505.81RVU17B
2017-01-01$505.81$505.81RVU17A
2016-10-01$505.29$505.29RVU16D
2016-07-01$505.29$505.29RVU16C
2016-04-01$505.29$505.29RVU16B
2016-01-01$505.29$505.29RVU16A
2015-10-01$507.09$506.66RVU15D
2015-07-01$507.09$506.66RVU15C
2015-04-01$504.57$504.14RVU15B
2015-01-01$504.57$504.14RVU15A
2014-10-01$500.87$500.87RVU14D
2014-07-01$500.87$500.87RVU14C
2014-04-01$500.87$500.87RVU14B
2014-01-01$500.87$500.87RVU14A
2013-10-01$488.36$488.36RVU13D
2013-07-01$488.36$488.36RVU13C
2013-04-01$488.36$488.36RVU13B
2013-01-01$488.36$488.36RVU13AR

Price 90965 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

90965 billing questions

How does this differ from 90964 or 90966?

Those codes represent monthly ESRD-related services for home dialysis patients in different age groups: 90964 for ages 2 through 11 and 90966 for age 20 or older. Use 90965 for ages 12 through 19.

Is this billed for each home dialysis treatment?

No. It represents monthly ESRD-related management, not an individual dialysis session.

What if the practitioner provides services for only part of the month?

Use the applicable age-specific per-day code, 90969, for a patient ages 12 through 19 when the service period is less than a full month.

What documentation supports reporting 90965?

Document the patient’s age, home-dialysis status, and the ESRD-related clinical management provided during the month.

When would 90957 be considered instead?

90957 is in the age 12-through-19 ESRD monthly service series based on monthly visit count, rather than the home-dialysis series. Choose the code family that matches the patient’s dialysis situation and services.

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 90965PPRRVU2026_Oct_nonQPP.csv, line 11,578 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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