CPT code 90966: Home dialysis, monthly, age 20 and older2026 Medicare rate & RVUs in South Carolina
Monthly ESRD-related management for a patient age 20 or older receiving dialysis at home, including ongoing assessment and management of the dialysis plan.
In South Carolina, Medicare pays $299.83 for 90966 in the office and $299.83 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 90966 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 90966 covers
This code represents a month of ESRD-related management for an adult receiving dialysis at home, such as home hemodialysis or peritoneal dialysis. A nephrologist or other qualified clinician manages the patient’s dialysis care, assessing clinical status and addressing the treatment plan, relevant results, and related care needs. Services may be furnished through an outpatient nephrology practice while the patient performs dialysis at home.
Select the code based on the patient’s age and home dialysis setting, not on the number of monthly visits. Documentation should identify the home modality and support the ESRD-related assessment and management furnished during the month. For a patient age 20 or older whose ESRD services cover only part of a month, consider the age-matched per-day code rather than reporting this monthly service as a visit-count level.
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 South Carolina compares for 90966
Across 109 of 109 payment localities, the office rate for 90966 runs from $288.40 in Arkansas to $404.49 in Alaska. South Carolina pays $299.83. The RVUs are the same everywhere; the geographic indexes change the dollars.
- South Carolina · this page$299.83
- Los Angeles, CA · California$334.66+$34.83
- Washington, DC area · District of Columbia$341.88+$42.05
- Miami, FL · Florida$333.35+$33.52
- Chicago, IL · Illinois$327.73+$27.90
- Manhattan, NY · New York$347.59+$47.76
- Alaska · Alaska$404.49+$104.66
Other areas in South Carolina first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $290.84 | $290.84 |
| ArkansasArkansas | $288.40 | $288.40 |
| ArizonaArizona | $305.03 | $305.03 |
| Bakersfield, CACalifornia | $320.03 | $320.03 |
| Chico, CACalifornia | $318.78 | $318.78 |
| El Centro, CACalifornia | $318.84 | $318.84 |
| Fresno, CACalifornia | $318.78 | $318.78 |
| Hanford, CACalifornia | $318.78 | $318.78 |
| Madera, CACalifornia | $318.78 | $318.78 |
| Merced, CACalifornia | $318.78 | $318.78 |
| Modesto, CACalifornia | $318.78 | $318.78 |
| Napa, CACalifornia | $352.21 | $352.21 |
| Oxnard, CACalifornia | $331.65 | $331.65 |
| Redding, CACalifornia | $318.78 | $318.78 |
| Rest of CaliforniaCalifornia | $318.78 | $318.78 |
| Riverside, CACalifornia | $322.78 | $322.78 |
| Sacramento, CACalifornia | $329.92 | $329.92 |
| Salinas, CACalifornia | $328.54 | $328.54 |
| San Diego, CACalifornia | $332.64 | $332.64 |
| Marin County, CACalifornia | $368.00 | $368.00 |
| San Francisco, CACalifornia | $367.59 | $367.59 |
| San Benito County, CACalifornia | $375.34 | $375.34 |
| Santa Clara County, CACalifornia | $373.67 | $373.67 |
| San Luis Obispo, CACalifornia | $323.68 | $323.68 |
| Santa Cruz, CACalifornia | $333.07 | $333.07 |
| Santa Maria, CACalifornia | $328.78 | $328.78 |
| Santa Rosa, CACalifornia | $336.21 | $336.21 |
| Stockton, CACalifornia | $318.78 | $318.78 |
| Vallejo, CACalifornia | $351.62 | $351.62 |
| Visalia, CACalifornia | $318.78 | $318.78 |
| Yuba City, CACalifornia | $318.78 | $318.78 |
| ColoradoColorado | $317.16 | $317.16 |
| ConnecticutConnecticut | $325.28 | $325.28 |
| DelawareDelaware | $308.64 | $308.64 |
| Fort Lauderdale, FLFlorida | $321.49 | $321.49 |
| Rest of FloridaFlorida | $311.33 | $311.33 |
| Atlanta, GAGeorgia | $315.09 | $315.09 |
| Rest of GeorgiaGeorgia | $300.30 | $300.30 |
| Hawaii, Guam, HIHawaii | $320.84 | $320.84 |
| IowaIowa | $293.36 | $293.36 |
| IdahoIdaho | $294.85 | $294.85 |
| East St. Louis, ILIllinois | $313.38 | $313.38 |
| Rest of IllinoisIllinois | $307.16 | $307.16 |
| Suburban Chicago, ILIllinois | $323.94 | $323.94 |
| IndianaIndiana | $295.80 | $295.80 |
| KansasKansas | $293.40 | $293.40 |
| KentuckyKentucky | $296.63 | $296.63 |
| New Orleans, LALouisiana | $305.21 | $305.21 |
| Rest of LouisianaLouisiana | $296.69 | $296.69 |
| Metropolitan Boston, MAMassachusetts | $338.63 | $338.63 |
| Rest of MassachusettsMassachusetts | $316.84 | $316.84 |
| Baltimore area, MDMaryland | $324.41 | $324.41 |
| Rest of MarylandMaryland | $312.52 | $312.52 |
| Rest of MaineMaine | $296.64 | $296.64 |
| Southern Maine, MEMaine | $304.83 | $304.83 |
| Detroit, MIMichigan | $314.56 | $314.56 |
| Rest of MichiganMichigan | $301.94 | $301.94 |
| MinnesotaMinnesota | $305.13 | $305.13 |
| Metropolitan Kansas City, MOMissouri | $303.07 | $303.07 |
| Metropolitan St. Louis, MOMissouri | $304.85 | $304.85 |
| Rest of MissouriMissouri | $294.26 | $294.26 |
| MississippiMississippi | $291.32 | $291.32 |
| MontanaMontana | $310.27 | $310.27 |
| North CarolinaNorth Carolina | $298.32 | $298.32 |
| North DakotaNorth Dakota | $303.15 | $303.15 |
| NebraskaNebraska | $294.05 | $294.05 |
| New HampshireNew Hampshire | $313.46 | $313.46 |
| Northern New JerseyNew Jersey | $340.95 | $340.95 |
| Rest of New JerseyNew Jersey | $329.31 | $329.31 |
| New MexicoNew Mexico | $303.26 | $303.26 |
| NevadaNevada | $308.40 | $308.40 |
| NYC suburbs and Long Island, NYNew York | $353.93 | $353.93 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $331.94 | $331.94 |
| Queens, NYNew York | $348.14 | $348.14 |
| Rest of New YorkNew York | $301.03 | $301.03 |
| OhioOhio | $300.48 | $300.48 |
| OklahomaOklahoma | $295.43 | $295.43 |
| Portland, OROregon | $322.81 | $322.81 |
| Rest of OregonOregon | $306.27 | $306.27 |
| Metropolitan Philadelphia, PAPennsylvania | $320.60 | $320.60 |
| Rest of PennsylvaniaPennsylvania | $300.29 | $300.29 |
| Puerto RicoPuerto Rico | $311.37 | $311.37 |
| Rhode IslandRhode Island | $316.26 | $316.26 |
| South DakotaSouth Dakota | $302.31 | $302.31 |
| TennesseeTennessee | $294.36 | $294.36 |
| Austin, TXTexas | $315.90 | $315.90 |
| Beaumont, TXTexas | $299.19 | $299.19 |
| Brazoria, TXTexas | $308.10 | $308.10 |
| Dallas, TXTexas | $309.79 | $309.79 |
| Fort Worth, TXTexas | $308.81 | $308.81 |
| Galveston, TXTexas | $308.90 | $308.90 |
| Houston, TXTexas | $315.49 | $315.49 |
| Rest of TexasTexas | $303.32 | $303.32 |
| UtahUtah | $302.23 | $302.23 |
| VirginiaVirginia | $304.82 | $304.82 |
| Virgin Islands, VIUnited States Virgin Islands | $311.37 | $311.37 |
| VermontVermont | $303.22 | $303.22 |
| Rest of WashingtonWashington | $315.85 | $315.85 |
| King County, WAWashington | $343.17 | $343.17 |
| WisconsinWisconsin | $297.19 | $297.19 |
| West VirginiaWest Virginia | $300.56 | $300.56 |
| WyomingWyoming | $307.17 | $307.17 |
90966 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.
$288.40
$404.49
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 | $404.49 | 1 |
| AL | $290.84 | 1 |
| AR | $288.40 | 1 |
| AZ | $305.03 | 1 |
| CA | $318.78–$375.34 | 29 |
| CO | $317.16 | 1 |
| CT | $325.28 | 1 |
| DC | $341.88 | 1 |
| DE | $308.64 | 1 |
| FL | $311.33–$333.35 | 3 |
| GA | $300.30–$315.09 | 2 |
| GU | $320.84 | 1 |
| HI | $320.84 | 1 |
| IA | $293.36 | 1 |
| ID | $294.85 | 1 |
| IL | $307.16–$327.73 | 4 |
| IN | $295.80 | 1 |
| KS | $293.40 | 1 |
| KY | $296.63 | 1 |
| LA | $296.69–$305.21 | 2 |
| MA | $316.84–$338.63 | 2 |
| MD | $312.52–$341.88 | 3 |
| ME | $296.64–$304.83 | 2 |
| MI | $301.94–$314.56 | 2 |
| MN | $305.13 | 1 |
| MO | $294.26–$304.85 | 3 |
| MS | $291.32 | 1 |
| MT | $310.27 | 1 |
| NC | $298.32 | 1 |
| ND | $303.15 | 1 |
| NE | $294.05 | 1 |
| NH | $313.46 | 1 |
| NJ | $329.31–$340.95 | 2 |
| NM | $303.26 | 1 |
| NV | $308.40 | 1 |
| NY | $301.03–$353.93 | 5 |
| OH | $300.48 | 1 |
| OK | $295.43 | 1 |
| OR | $306.27–$322.81 | 2 |
| PA | $300.29–$320.60 | 2 |
| PR | $311.37 | 1 |
| RI | $316.26 | 1 |
| SC | $299.83 | 1 |
| SD | $302.31 | 1 |
| TN | $294.36 | 1 |
| TX | $299.19–$315.90 | 8 |
| UT | $302.23 | 1 |
| VA | $304.82–$341.88 | 2 |
| VI | $311.37 | 1 |
| VT | $303.22 | 1 |
| WA | $315.85–$343.17 | 2 |
| WI | $297.19 | 1 |
| WV | $300.56 | 1 |
| WY | $307.17 | 1 |
How the 90966 rate is calculated
Each of 90966’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 · 90966
RVUs × geographic indexes × conversion factor
Work5.52
5.52 RVUs× 1.000 GPCI
Practice expense3.41
3.41 RVUs× 1.000 GPCI
Malpractice0.36
0.36 RVUs× 1.000 GPCI
Adjusted RVUs
9.2900
Conversion factor
$33.4009
Medicare rate
$310.29
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact South Carolina inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
11,579
- Code
- 90966
- Physician work
- 5.52
- Practice expense
- 3.41
- Malpractice
- 0.36
GPCI2026.csv
93
- Locality
- South Carolina
- Physician work
- 1.000
- Practice expense
- 0.924
- Malpractice
- 0.850
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.52 | × 1.000 | 5.5200 |
| Practice expense | 3.41 | × 0.924 | 3.1508 |
| Malpractice | 0.36 | × 0.850 | 0.3060 |
| Total RVUs | 8.9768 | ||
| Conversion factor | × 33.4009 | ||
Office rate, South Carolina$299.83
Office: (5.52 × 1 + 3.41 × 0.924 + 0.36 × 0.85) × $33.4009 = $299.83
Facility: (5.52 × 1 + 3.41 × 0.924 + 0.36 × 0.85) × $33.4009 = $299.83
Payment rules and modifiers for 90966
90966 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 · 90966
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$310.29
- Non-facility (office)
- $310.29
- Facility
- $310.29
Higher because the practice carries its own overhead.
How 90966 has changed in South Carolina
90966 · Office / nonfacility
$299.83
Effective 2026-10-01
The base rate is $25.47 higher than on 2025-10-01, moving from $274.36 to $299.83 (9.3%).
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
$274.36changed to$299.83
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 2.94 changed to 3.41
- Malpractice RVU 0.34 changed to 0.36
- Practice expense GPCI 0.913 changed to 0.924
- Malpractice GPCI 0.817 changed to 0.850
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$279.91changed to$274.36
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 2.86 changed to 2.94
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$275.34changed to$279.91
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$281.61changed to$275.34
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 2.79 changed to 2.86
- Practice expense GPCI 0.908 changed to 0.913
- Malpractice GPCI 0.756 changed to 0.817
January 1, 2023
RVU23A
$286.70changed to$281.61
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 2.80 changed to 2.79
- Practice expense GPCI 0.903 changed to 0.908
- Malpractice GPCI 0.695 changed to 0.756
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$286.95changed to$286.70
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 2.74 changed to 2.80
- Malpractice RVU 0.33 changed to 0.34
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$233.25changed to$286.95
- Conversion factor 36.0896 changed to 34.8931
- Work RVU 4.26 changed to 5.52
- Practice expense RVU 2.25 changed to 2.74
- Malpractice RVU 0.26 changed to 0.33
- Practice expense GPCI 0.907 changed to 0.903
- Malpractice GPCI 0.624 changed to 0.695
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$231.28changed to$233.25
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 2.22 changed to 2.25
- Malpractice RVU 0.24 changed to 0.26
- Practice expense GPCI 0.912 changed to 0.907
- Malpractice GPCI 0.553 changed to 0.624
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$231.02changed to$231.28
- Conversion factor 35.9996 changed to 36.0391
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$230.35changed to$231.02
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 2.20 changed to 2.22
- Malpractice GPCI 0.634 changed to 0.553
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$231.16changed to$230.35
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 2.22 changed to 2.20
- Malpractice GPCI 0.715 changed to 0.634
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$231.67changed to$231.16
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 2.21 changed to 2.22
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$230.51changed to$231.67
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$230.59changed to$230.51
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 2.22 changed to 2.21
- Malpractice RVU 0.25 changed to 0.24
- Practice expense GPCI 0.911 changed to 0.912
- Malpractice GPCI 0.618 changed to 0.715
Held through RVU15B.
January 1, 2014
RVU14A
$225.31changed to$230.59
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 2.45 changed to 2.22
- Malpractice RVU 0.26 changed to 0.25
- Practice expense GPCI 0.909 changed to 0.911
- Malpractice GPCI 0.520 changed to 0.618
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $225.31
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $299.83 | $299.83 | RVU26D |
| 2026-07-01 | $299.83 | $299.83 | RVU26C |
| 2026-04-01 | $299.83 | $299.83 | RVU26B |
| 2026-01-01 | $299.83 | $299.83 | RVU26A |
| 2025-10-01 | $274.36 | $274.36 | RVU25D |
| 2025-07-01 | $274.36 | $274.36 | RVU25C |
| 2025-04-01 | $274.36 | $274.36 | RVU25B |
| 2025-01-01 | $274.36 | $274.36 | RVU25A |
| 2024-10-01 | $279.91 | $279.91 | RVU24D |
| 2024-07-01 | $279.91 | $279.91 | RVU24C |
| 2024-04-01 | $279.91 | $279.91 | RVU24B |
| 2024-03-09 | $279.91 | $279.91 | RVU24AR |
| 2024-01-01 | $275.34 | $275.34 | RVU24A |
| 2023-10-01 | $281.61 | $281.61 | RVU23D |
| 2023-07-01 | $281.61 | $281.61 | RVU23C |
| 2023-04-01 | $281.61 | $281.61 | RVU23B |
| 2023-01-01 | $281.61 | $281.61 | RVU23A |
| 2022-10-01 | $286.70 | $286.70 | RVU22D |
| 2022-07-01 | $286.70 | $286.70 | RVU22C |
| 2022-04-01 | $286.70 | $286.70 | RVU22B |
| 2022-01-01 | $286.70 | $286.70 | RVU22A |
| 2021-10-01 | $286.95 | $286.95 | RVU21D |
| 2021-07-01 | $286.95 | $286.95 | RVU21C |
| 2021-04-01 | $286.95 | $286.95 | RVU21B |
| 2021-01-01 | $286.95 | $286.95 | RVU21A |
| 2020-10-01 | $233.25 | $233.25 | RVU20D |
| 2020-07-01 | $233.25 | $233.25 | RVU20C |
| 2020-04-01 | $233.25 | $233.25 | RVU20B |
| 2020-01-01 | $233.25 | $233.25 | RVU20A |
| 2019-10-01 | $231.28 | $231.28 | RVU19D |
| 2019-07-01 | $231.28 | $231.28 | RVU19C |
| 2019-04-01 | $231.28 | $231.28 | RVU19B |
| 2019-01-01 | $231.28 | $231.28 | RVU19A |
| 2018-10-01 | $231.02 | $231.02 | RVU18D |
| 2018-07-01 | $231.02 | $231.02 | RVU18C |
| 2018-04-01 | $231.02 | $231.02 | RVU18B |
| 2018-01-01 | $231.02 | $231.02 | RVU18AR1 |
| 2017-10-01 | $230.35 | $230.35 | RVU17D |
| 2017-07-01 | $230.35 | $230.35 | RVU17C |
| 2017-04-01 | $230.35 | $230.35 | RVU17B |
| 2017-01-01 | $230.35 | $230.35 | RVU17A |
| 2016-10-01 | $231.16 | $231.16 | RVU16D |
| 2016-07-01 | $231.16 | $231.16 | RVU16C |
| 2016-04-01 | $231.16 | $231.16 | RVU16B |
| 2016-01-01 | $231.16 | $231.16 | RVU16A |
| 2015-10-01 | $231.67 | $231.67 | RVU15D |
| 2015-07-01 | $231.67 | $231.67 | RVU15C |
| 2015-04-01 | $230.51 | $230.51 | RVU15B |
| 2015-01-01 | $230.51 | $230.51 | RVU15A |
| 2014-10-01 | $230.59 | $230.59 | RVU14D |
| 2014-07-01 | $230.59 | $230.59 | RVU14C |
| 2014-04-01 | $230.59 | $230.59 | RVU14B |
| 2014-01-01 | $230.59 | $230.59 | RVU14A |
| 2013-10-01 | $225.31 | $225.31 | RVU13D |
| 2013-07-01 | $225.31 | $225.31 | RVU13C |
| 2013-04-01 | $225.31 | $225.31 | RVU13B |
| 2013-01-01 | $225.31 | $225.31 | RVU13AR |
Where the South Carolina rate applies
South Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 475 cities and communities in South Carolina. Some span more than one payment area; confirm with the service ZIP.
- Abbeville
- Abney Crossroads
- Adams Run
- Aiken
- Alcolu
- Allendale
- Anderson
- Andrews
90966 billing questions
Does the number of visits during the month determine whether 90966 applies?
No. The monthly home dialysis code is selected by age and dialysis setting, rather than by the visit-count levels used for in-center ESRD services.
How does 90966 differ from 90965?
Both are monthly home dialysis management codes; 90966 is for patients age 20 or older, while 90965 is for patients ages 12 through 19.
What code is used when home dialysis services cover only part of a month?
For a patient age 20 or older, the per-day counterpart is 90970. Use the code that reflects the patient’s age and the service period.
Is 90966 for home hemodialysis, peritoneal dialysis, or both?
It applies to home dialysis management, including home hemodialysis and peritoneal dialysis.
What should the record support?
Document the patient’s age, home dialysis modality, month of management, and the ESRD-related assessment and management provided.
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
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