Billing code 90964: ESRD servicesMedicare rate & RVUs
Report this monthly physician service for ongoing ESRD-related care of a patient ages 2 through 11 who receives dialysis at home.
Medicare pays $534.08 for 90964 nationally in the office and $534.08 in a hospital or facility. Local office rates run $499.92–$707.08.
Medicare rate · 90964
ESRD services
Swap in your local Medicare rate.
- Work RVUs
- 10.25
- Total RVUs
- 15.99
- Global days
- XXX
National rate · 2026
$534.08
Office setting, before claim adjustments.
See every locality for 90964 → · Billed by an NP, PA or therapist? →
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 10 sections
What 90964 covers
This code represents a month of physician management for a child ages 2 through 11 receiving home dialysis. A nephrologist typically assesses the child’s dialysis-related status, reviews treatment and laboratory information, and manages issues such as fluid balance, blood pressure, medications, vascular access, and dialysis complications. Care may involve coordination with the family and the home dialysis team in an outpatient setting.
Select the code based on the patient’s age and home-dialysis status for the month. Documentation should support the patient’s age, home dialysis, and the physician’s ESRD-related management during that month. This is a monthly service code, not a code for each home dialysis session. For a partial month, compare the circumstances with the applicable per-day ESRD service code rather than treating this as a per-session service.
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.
Where 90964 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$499.92 to $707.08
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $503.72 | $503.72 |
| Alaska* | $707.08 | $707.08 |
| Arizona | $525.80 | $525.80 |
| Arkansas | $499.92 | $499.92 |
| Atlanta | $542.01 | $542.01 |
| Austin | $542.32 | $542.32 |
| Bakersfield | $548.91 | $548.91 |
| Baltimore/Surr. Cntys | $556.95 | $556.95 |
| Beaumont | $517.22 | $517.22 |
| Brazoria | $530.72 | $530.72 |
| Chicago | $564.15 | $564.15 |
| Chico | $546.71 | $546.71 |
| Colorado | $544.60 | $544.60 |
| Connecticut | $558.44 | $558.44 |
| Dallas | $533.54 | $533.54 |
| Dc + Md/Va Suburbs | $585.35 | $585.35 |
| Delaware | $531.65 | $531.65 |
| Detroit | $542.30 | $542.30 |
| East St. Louis | $541.40 | $541.40 |
| El Centro | $546.81 | $546.81 |
| Fort Lauderdale | $553.04 | $553.04 |
| Fort Worth | $532.10 | $532.10 |
| Fresno | $546.71 | $546.71 |
| Galveston | $532.06 | $532.06 |
| Hanford-Corcoran | $546.71 | $546.71 |
| Hawaii, Guam | $548.79 | $548.79 |
| Houston | $543.41 | $543.41 |
| Idaho | $509.49 | $509.49 |
| Indiana | $510.95 | $510.95 |
| Iowa | $507.06 | $507.06 |
| Kansas | $507.39 | $507.39 |
| Kentucky | $513.34 | $513.34 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $572.45 | $572.45 |
| Madera | $546.71 | $546.71 |
| Manhattan | $595.83 | $595.83 |
| Merced | $546.71 | $546.71 |
| Metropolitan Boston | $579.02 | $579.02 |
| Metropolitan Kansas City | $523.17 | $523.17 |
| Metropolitan Philadelphia | $551.25 | $551.25 |
| Metropolitan St. Louis | $525.91 | $525.91 |
| Miami | $572.76 | $572.76 |
| Minnesota | $524.46 | $524.46 |
| Mississippi | $504.90 | $504.90 |
| Modesto | $546.71 | $546.71 |
| Montana** | $534.04 | $534.04 |
| Napa | $599.84 | $599.84 |
| Nebraska | $508.03 | $508.03 |
| Nevada** | $530.79 | $530.79 |
| New Hampshire | $538.50 | $538.50 |
| New Mexico | $524.05 | $524.05 |
| New Orleans | $526.81 | $526.81 |
| North Carolina | $515.15 | $515.15 |
| North Dakota** | $521.78 | $521.78 |
| Northern Nj | $584.42 | $584.42 |
| Nyc Suburbs/Long Island | $606.06 | $606.06 |
| Ohio | $519.37 | $519.37 |
| Oklahoma | $511.16 | $511.16 |
| Oxnard-Thousand Oaks-Ventura | $566.98 | $566.98 |
| Portland | $553.24 | $553.24 |
| Poughkpsie/N Nyc Suburbs | $570.08 | $570.08 |
| Puerto Rico | $535.65 | $535.65 |
| Queens | $596.27 | $596.27 |
| Redding | $546.71 | $546.71 |
| Rest Of California | $546.71 | $546.71 |
| Rest Of Florida | $536.97 | $536.97 |
| Rest Of Georgia | $519.59 | $519.59 |
| Rest Of Illinois | $530.86 | $530.86 |
| Rest Of Louisiana | $513.54 | $513.54 |
| Rest Of Maine | $512.57 | $512.57 |
| Rest Of Maryland | $537.86 | $537.86 |
| Rest Of Massachusetts | $544.42 | $544.42 |
| Rest Of Michigan | $521.87 | $521.87 |
| Rest Of Missouri | $509.94 | $509.94 |
| Rest Of New Jersey | $565.52 | $565.52 |
| Rest Of New York | $519.38 | $519.38 |
| Rest Of Oregon | $527.25 | $527.25 |
| Rest Of Pennsylvania | $518.92 | $518.92 |
| Rest Of Texas | $523.35 | $523.35 |
| Rest Of Washington | $542.65 | $542.65 |
| Rhode Island | $543.99 | $543.99 |
| Riverside-San Bernardino-Ontario | $553.62 | $553.62 |
| Sacramento-Roseville-Folsom | $564.67 | $564.67 |
| Salinas | $562.28 | $562.28 |
| San Diego-Chula Vista-Carlsbad | $568.39 | $568.39 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $625.52 | $625.52 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $624.81 | $624.81 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $637.72 | $637.72 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $634.84 | $634.84 |
| San Luis Obispo-Paso Robles | $554.06 | $554.06 |
| Santa Cruz-Watsonville | $568.43 | $568.43 |
| Santa Maria-Santa Barbara | $562.45 | $562.45 |
| Santa Rosa-Petaluma | $573.73 | $573.73 |
| Seattle (King Cnty) | $586.23 | $586.23 |
| South Carolina | $517.98 | $517.98 |
| South Dakota** | $520.33 | $520.33 |
| Southern Maine | $524.90 | $524.90 |
| Stockton | $546.71 | $546.71 |
| Suburban Chicago | $557.08 | $557.08 |
| Tennessee | $508.93 | $508.93 |
| Utah | $521.71 | $521.71 |
| Vallejo | $598.83 | $598.83 |
| Vermont | $522.14 | $522.14 |
| Virgin Islands | $535.65 | $535.65 |
| Virginia | $525.08 | $525.08 |
| Visalia | $546.71 | $546.71 |
| West Virginia | $520.60 | $520.60 |
| Wisconsin | $512.57 | $512.57 |
| Wyoming** | $528.70 | $528.70 |
| Yuba City | $546.71 | $546.71 |
90964 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.
$499.92
$707.08
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 | $707.08 | 1 |
| AL | $503.72 | 1 |
| AR | $499.92 | 1 |
| AZ | $525.80 | 1 |
| CA | $546.71–$637.72 | 29 |
| CO | $544.60 | 1 |
| CT | $558.44 | 1 |
| DC | $585.35 | 1 |
| DE | $531.65 | 1 |
| FL | $536.97–$572.76 | 3 |
| GA | $519.59–$542.01 | 2 |
| GU | $548.79 | 1 |
| HI | $548.79 | 1 |
| IA | $507.06 | 1 |
| ID | $509.49 | 1 |
| IL | $530.86–$564.15 | 4 |
| IN | $510.95 | 1 |
| KS | $507.39 | 1 |
| KY | $513.34 | 1 |
| LA | $513.54–$526.81 | 2 |
| MA | $544.42–$579.02 | 2 |
| MD | $537.86–$585.35 | 3 |
| ME | $512.57–$524.90 | 2 |
| MI | $521.87–$542.30 | 2 |
| MN | $524.46 | 1 |
| MO | $509.94–$525.91 | 3 |
| MS | $504.90 | 1 |
| MT | $534.04 | 1 |
| NC | $515.15 | 1 |
| ND | $521.78 | 1 |
| NE | $508.03 | 1 |
| NH | $538.50 | 1 |
| NJ | $565.52–$584.42 | 2 |
| NM | $524.05 | 1 |
| NV | $530.79 | 1 |
| NY | $519.38–$606.06 | 5 |
| OH | $519.37 | 1 |
| OK | $511.16 | 1 |
| OR | $527.25–$553.24 | 2 |
| PA | $518.92–$551.25 | 2 |
| PR | $535.65 | 1 |
| RI | $543.99 | 1 |
| SC | $517.98 | 1 |
| SD | $520.33 | 1 |
| TN | $508.93 | 1 |
| TX | $517.22–$543.41 | 8 |
| UT | $521.71 | 1 |
| VA | $525.08–$585.35 | 2 |
| VI | $535.65 | 1 |
| VT | $522.14 | 1 |
| WA | $542.65–$586.23 | 2 |
| WI | $512.57 | 1 |
| WV | $520.60 | 1 |
| WY | $528.70 | 1 |
How the 90964 rate is calculated
Each of 90964’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 · 90964
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 10.25Practice expense 5.12Malpractice 0.62
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 90964
90964 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 · 90964
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
Non-facility (office) rate · national
$534.08
The facility rate would be $534.08 (−$0.00). In a facility, the facility bills its own costs separately.
90964 compared with similar codes
Compare codes
90964 vs 90963 vs 90965 vs 90968 vs 90954: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 90963ESRD management
- Both report monthly ESRD-related services for home dialysis; 90963 is for patients younger than 2, while 90964 is for ages 2 through 11.
- 90965Home dialysis
- Both are monthly home-dialysis ESRD service codes. Use 90965 for ages 12 through 19 and 90964 for ages 2 through 11.
- 90968ESRD daily care
- Code 90968 represents per-day ESRD services for home-dialysis patients ages 2 through 11; 90964 represents the monthly service for that age group.
- 90954ESRD management
- Code 90954 applies to a different dialysis setting and visit-count category for patients ages 2 through 11; 90964 is the monthly home-dialysis code.
90964 billing questions
How is 90964 distinguished from 90963 and 90965?
These are monthly home-dialysis ESRD service codes distinguished by patient age. Code 90964 is for ages 2 through 11; 90963 is for patients younger than 2, and 90965 is for ages 12 through 19.
Is 90964 reported for every home dialysis treatment?
No. It represents monthly ESRD-related physician management, not an individual dialysis session.
What documentation supports reporting 90964?
Document the patient’s age, home-dialysis status, and the ESRD-related assessment and management provided during the month.
When should a per-day code be considered instead?
Consider the age-appropriate per-day ESRD service code when the applicable circumstances involve a partial month. Code 90968 is the per-day code for ages 2 through 11.
How does 90964 differ from 90954?
Both relate to patients ages 2 through 11, but 90964 is for home dialysis. Code 90954 is a monthly ESRD service code for a different dialysis setting and visit-count category.
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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