CPT code 90968: ESRD daily care, ages 2–11, partial month2026 Medicare rate & RVUs in Chicago, IL

In Chicago, IL, Medicare pays $18.68 for 90968 in the office and $18.68 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 90968 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 90968 covers

A nephrologist or other qualified clinician reports 90968 for ESRD-related management of a dialysis patient age 2 through 11 when care covers less than a full month. A partial month may occur when a patient begins care after a transfer or starts dialysis, or when care ends during the month after a transplant or another change. The service reflects ongoing ESRD management, such as assessing dialysis-related status and coordinating the care plan; it is not a code for each dialysis run.

The payment unit is a day. Report the code for the days of ESRD-related care in the partial-month period, rather than selecting it by dialysis-session count. Documentation should support the patient’s age, the dates of care, why the period is less than a full month, and the ESRD management provided. For a complete month, choose the applicable monthly ESRD service code based on the care setting and monthly visit category.

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 Chicago, IL compares for 90968

Across 109 of 109 payment localities, the office rate for 90968 runs from $16.58 in Arkansas to $23.45 in Alaska. Chicago, IL pays $18.68. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

90968 rates by state

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

See 90968 in every payment locality

How the 90968 rate is calculated

Each of 90968’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 90968

90968 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 90968

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

How 90968 has changed in Chicago, IL

Price 90968 for an earlier date of service

Where the Chicago, IL rate applies

Chicago, IL is a Medicare payment area, not a city. Our Census mapping connects it to 137 cities and communities in Illinois. Some span more than one payment area; confirm with the service ZIP.

• 90968 in Chicago · multiple payment areas
• Alsip
• Arlington Heights
• 90968 in Barrington · multiple payment areas
• 90968 in Barrington Hills · multiple payment areas
• 90968 in Bartlett · multiple payment areas
• Bedford Park
• Bellwood

Browse all communities in Illinois

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