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

In Tennessee, Medicare pays $491.42 for 90965 in the office and $491.42 when it’s performed in a hospital or facility.

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.

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 Tennessee 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. Tennessee pays $491.42. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

90965 rates by state

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

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.

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.

Codes related to 90965

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

How 90965 has changed in Tennessee

Price 90965 for an earlier date of service

Where the Tennessee rate applies

Tennessee is a Medicare payment area, not a city. Our Census mapping connects it to 504 cities and communities in Tennessee. Some span more than one payment area; confirm with the service ZIP.

• Adams
• Adamsville
• Alamo
• Alcoa
• Alexandria
• Algood
• Allardt
• Altamont

Browse all communities in Tennessee

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

Open CMS sourceHow we calculate rates