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

Reports daily ESRD-related management for a dialysis patient age 2 through 11 when the clinician’s care covers less than a full month.

CMS RVU26DEffective Oct 1, 2026One payment locality2.1K Medicare services in 2024

In Kansas, Medicare pays $16.83 for 90968 in the office and $16.83 when it’s performed in a hospital or facility.

$16.83Office (non-facility)
$16.83Hospital or facility
−4.9%vs the national office rate ($17.70)

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.

We’ll open 90968 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Kansas
  2. What 90968 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 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 Kansas 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. Kansas pays $16.83. The RVUs are the same everywhere; the geographic indexes change the dollars.

90968 in Kansas vs other payment areas
  1. Kansas · this page$16.83
  2. Los Angeles, CA · California$18.98+$2.15
  3. Washington, DC area · District of Columbia$19.40+$2.57
  4. Miami, FL · Florida$18.96+$2.13
  5. Chicago, IL · Illinois$18.68+$1.85
  6. Manhattan, NY · New York$19.74+$2.91
  7. Alaska · Alaska$23.45+$6.62

Other areas in Kansas first, then benchmark localities. Bars start at $0.

Every other payment area

90968 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$16.70$16.70
ArkansasArkansas$16.58$16.58
ArizonaArizona$17.43$17.43
Bakersfield, CACalifornia$18.20$18.20
Chico, CACalifornia$18.13$18.13
El Centro, CACalifornia$18.13$18.13
Fresno, CACalifornia$18.13$18.13
Hanford, CACalifornia$18.13$18.13

90968 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.

$16.58

$23.45

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

View every state and territory as a table
90968 office rate range by state
State / territoryOffice rate rangeLocalities
AK$23.451
AL$16.701
AR$16.581
AZ$17.431
CA$18.13–$21.1529
CO$18.061
CT$18.511
DC$19.401
DE$17.621
FL$17.79–$18.963
GA$17.22–$17.962
GU$18.201
HI$18.201
IA$16.821
ID$16.901
IL$17.58–$18.684
IN$16.941
KS$16.831
KY$17.021
LA$17.02–$17.462
MA$18.05–$19.202
MD$17.83–$19.403
ME$17.00–$17.402
MI$17.29–$17.962
MN$17.401
MO$16.90–$17.433
MS$16.741
MT$17.701
NC$17.081
ND$17.311
NE$16.851
NH$17.851
NJ$18.74–$19.372
NM$17.371
NV$17.601
NY$17.22–$20.075
OH$17.211
OK$16.951
OR$17.48–$18.342
PA$17.20–$18.272
PR$17.751
RI$18.031
SC$17.171
SD$17.261
TN$16.881
TX$17.14–$18.008
UT$17.291
VA$17.41–$19.402
VI$17.751
VT$17.321
WA$17.99–$19.442
WI$17.001
WV$17.251
WY$17.531

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.

How the rate is built · 90968

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.34

0.34 RVUs× 1.000 GPCI

Practice expense0.17

0.17 RVUs× 1.000 GPCI

Malpractice0.02

0.02 RVUs× 1.000 GPCI

Adjusted RVUs

0.5300

Conversion factor

$33.4009

Medicare rate

$17.70

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

The exact Kansas inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,581

Code
90968
Physician work
0.34
Practice expense
0.17
Malpractice
0.02

GPCI2026.csv

54

Locality
Kansas
Physician work
1.000
Practice expense
0.904
Malpractice
0.504
Office calculation for 90968 in Kansas
ComponentRVULocality factorAdjusted
Physician work0.34× 1.0000.3400
Practice expense0.17× 0.9040.1537
Malpractice0.02× 0.5040.0101
Total RVUs0.5038
Conversion factor× 33.4009

Office rate, Kansas$16.83

Office: (0.34 × 1 + 0.17 × 0.904 + 0.02 × 0.504) × $33.4009 = $16.83

Facility: (0.34 × 1 + 0.17 × 0.904 + 0.02 × 0.504) × $33.4009 = $16.83

Open 90968 in the RVU calculator

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.

Place of service · 90968

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

$17.70

Non-facility (office)
$17.70
Facility
$17.70

Higher because the practice carries its own overhead.

Codes related to 90968

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

Codes related to 90968
CodeHow it relatesOffice range, Kansas
Same family
90967ESRD services, patient younger than 2Per-day ESRD-related services for a patient younger than 2.$17.46
90969Daily ESRD care, ages 12-19Per-day ESRD-related services for a patient age 12 through 19.$16.49
90970ESRD services, per day, age 20 or olderPer-day ESRD-related services for a patient age 20 or older.$9.50
Used instead
90955Monthly ESRD care, ages 2–11, 2–3 visitsMonthly ESRD services for ages 2–11 in the 2-to-3-visit category.$511.27
90964ESRD services, home dialysis, ages 2–11Monthly ESRD services for a home dialysis patient age 2–11.$507.39

How 90968 has changed in Kansas

90968 · Office / nonfacility

$16.83

Effective 2026-10-01

The base rate is $1.09 higher than on 2025-10-01, moving from $15.74 to $16.83 (6.9%).

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

    $15.74changed to$16.83

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.15 changed to 0.17
    • Practice expense GPCI 0.906 changed to 0.904
    • Malpractice GPCI 0.540 changed to 0.504

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $16.20changed to$15.74

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $15.94changed to$16.20

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $16.47changed to$15.94

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense GPCI 0.907 changed to 0.906
    • Malpractice GPCI 0.499 changed to 0.540

  5. January 1, 2023

    RVU23A

    $16.80changed to$16.47

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense GPCI 0.908 changed to 0.907
    • Malpractice GPCI 0.458 changed to 0.499

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $16.94changed to$16.80

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $15.48changed to$16.94

    • Conversion factor 36.0896 changed to 34.8931
    • Work RVU 0.30 changed to 0.34
    • Practice expense RVU 0.13 changed to 0.15
    • Practice expense GPCI 0.910 changed to 0.908
    • Malpractice GPCI 0.536 changed to 0.458

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $15.52changed to$15.48

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense GPCI 0.911 changed to 0.910
    • Malpractice GPCI 0.615 changed to 0.536

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $15.18changed to$15.52

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.12 changed to 0.13

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $15.13changed to$15.18

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense GPCI 0.907 changed to 0.911
    • Malpractice GPCI 0.639 changed to 0.615

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $15.10changed to$15.13

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 0.903 changed to 0.907
    • Malpractice GPCI 0.662 changed to 0.639

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $15.15changed to$15.10

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $15.07changed to$15.15

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $14.90changed to$15.07

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.01 changed to 0.02
    • Practice expense GPCI 0.899 changed to 0.903
    • Malpractice GPCI 0.810 changed to 0.662

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $14.49changed to$14.90

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.13 changed to 0.12
    • Practice expense GPCI 0.894 changed to 0.899
    • Malpractice GPCI 0.957 changed to 0.810

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $14.49

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$16.83$16.83RVU26D
2026-07-01$16.83$16.83RVU26C
2026-04-01$16.83$16.83RVU26B
2026-01-01$16.83$16.83RVU26A
2025-10-01$15.74$15.74RVU25D
2025-07-01$15.74$15.74RVU25C
2025-04-01$15.74$15.74RVU25B
2025-01-01$15.74$15.74RVU25A
2024-10-01$16.20$16.20RVU24D
2024-07-01$16.20$16.20RVU24C
2024-04-01$16.20$16.20RVU24B
2024-03-09$16.20$16.20RVU24AR
2024-01-01$15.94$15.94RVU24A
2023-10-01$16.47$16.47RVU23D
2023-07-01$16.47$16.47RVU23C
2023-04-01$16.47$16.47RVU23B
2023-01-01$16.47$16.47RVU23A
2022-10-01$16.80$16.80RVU22D
2022-07-01$16.80$16.80RVU22C
2022-04-01$16.80$16.80RVU22B
2022-01-01$16.80$16.80RVU22A
2021-10-01$16.94$16.94RVU21D
2021-07-01$16.94$16.94RVU21C
2021-04-01$16.94$16.94RVU21B
2021-01-01$16.94$16.94RVU21A
2020-10-01$15.48$15.48RVU20D
2020-07-01$15.48$15.48RVU20C
2020-04-01$15.48$15.48RVU20B
2020-01-01$15.48$15.48RVU20A
2019-10-01$15.52$15.52RVU19D
2019-07-01$15.52$15.52RVU19C
2019-04-01$15.52$15.52RVU19B
2019-01-01$15.52$15.52RVU19A
2018-10-01$15.18$15.18RVU18D
2018-07-01$15.18$15.18RVU18C
2018-04-01$15.18$15.18RVU18B
2018-01-01$15.18$15.18RVU18AR1
2017-10-01$15.13$15.13RVU17D
2017-07-01$15.13$15.13RVU17C
2017-04-01$15.13$15.13RVU17B
2017-01-01$15.13$15.13RVU17A
2016-10-01$15.10$15.10RVU16D
2016-07-01$15.10$15.10RVU16C
2016-04-01$15.10$15.10RVU16B
2016-01-01$15.10$15.10RVU16A
2015-10-01$15.15$15.15RVU15D
2015-07-01$15.15$15.15RVU15C
2015-04-01$15.07$15.07RVU15B
2015-01-01$15.07$15.07RVU15A
2014-10-01$14.90$14.90RVU14D
2014-07-01$14.90$14.90RVU14C
2014-04-01$14.90$14.90RVU14B
2014-01-01$14.90$14.90RVU14A
2013-10-01$14.49$14.49RVU13D
2013-07-01$14.49$14.49RVU13C
2013-04-01$14.49$14.49RVU13B
2013-01-01$14.49$14.49RVU13AR

Price 90968 for an earlier date of service

Where the Kansas rate applies

Kansas is a Medicare payment area, not a city. Our Census mapping connects it to 740 cities and communities in Kansas. Some span more than one payment area; confirm with the service ZIP.

  • Abbyville
  • Abilene
  • Ada
  • Admire
  • Agenda
  • Agra
  • Albert
  • Alden

Browse all communities in Kansas

90968 billing questions

How does 90968 differ from 90967 or 90969?

These per-day codes distinguish patient age: 90968 is for ages 2 through 11, 90967 for patients under 2, and 90969 for ages 12 through 19.

Can 90968 be reported for a full month of care?

No. It represents ESRD-related services for less than a full month. For a complete month, use the applicable monthly ESRD service code.

Is 90968 reported for each dialysis treatment?

No. Its unit is a day of ESRD-related care, not an individual dialysis run or session.

What documentation supports 90968?

Keep the patient’s age, dates of care establishing the partial-month period, and documentation of the ESRD-related management provided.

When might 90955 be used instead?

90955 is a monthly ESRD service code for a patient age 2 through 11 in the 2-to-3-visit category. It is for a full-month service period, unlike 90968.

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 90968PPRRVU2026_Oct_nonQPP.csv, line 11,581 (RVU26D)
Geographic factors for KansasGPCI2026.csv, line 54 (RVU26D)

Open CMS sourceHow we calculate rates

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