$353.64
Both describe monthly ESRD management for patients age 20 or older in the non-home monthly series. Use 90960 when the month includes four or more qualifying visits rather than one.
On this page
CMS RVU26D · Effective 2026-10-01
90962 ESRD monthly care Medicare reimbursement rates in Nebraska
Monthly ESRD-related management for a patient age 20 or older receiving facility-based dialysis when the physician or qualified professional makes one visit that month. Compare 90962 office and facility rates across CMS payment localities in Nebraska.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 90962 in Nebraska?
Nebraska has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$203.72
1 of 1 localities have a supported rate.
Payment area: Nebraska
One mapped payment locality.
Facility setting
$203.72
1 of 1 localities have a supported rate.
Payment area: Nebraska
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Nephrology
About 90962: Monthly ESRD care, one visit, age 20 or older
Monthly ESRD-related management for a patient age 20 or older receiving facility-based dialysis when the physician or qualified professional makes one visit that month.
This code represents monthly management of end-stage renal disease for an adult receiving dialysis outside the home-dialysis monthly service series. A nephrologist or other qualified health care professional typically evaluates the patient and manages ESRD-related concerns such as dialysis adequacy, vascular access, fluid status, anemia, medication needs, and complications. Care may involve coordination with the dialysis facility and the patient’s broader treatment team.
Report one unit for the calendar month when the patient is age 20 or older and the service meets the one-visit level. Select the monthly code using the patient’s age, dialysis setting or modality, and number of qualifying visits during the month; this code is distinct from levels for two or three visits and four or more visits. Documentation should support the visit and the monthly ESRD management provided. It represents monthly care, not a separate charge for each dialysis session.
Where the value comes from
- Work RVU3.57 · 55%
- Practice expense (office) RVU2.65 · 41%
- Malpractice RVU0.22 · 3%
125.9K
Medicare services in 2024 · #498 by national volume
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.
90962 compared with similar codes
Office rates for Nebraska, from the same CMS release.
$294.35
90961 is the two-to-three-visit monthly level for patients age 20 or older; 90962 is the one-visit level.
$294.05
90966 is the monthly service code for a patient age 20 or older receiving home dialysis. 90962 belongs to the non-home monthly series.
$9.53
90970 reports ESRD services by day for a patient age 20 or older when care covers only part of a month; 90962 is the one-visit monthly level.
Compare 90962 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Nebraska →
Office / nonfacility
$203.72
Facility
$203.72
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 90962 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
11,575
- Code
- 90962
- Physician work
- 3.57
- Practice expense
- 2.65
- Malpractice
- 0.22
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.57 | × 1.000 | 3.5700 |
| Practice expense | 2.65 | × 0.923 | 2.4459 |
| Malpractice | 0.22 | × 0.378 | 0.0832 |
| Total RVUs | 6.0991 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Nebraska$203.72
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.57 | 1 |
| Practice expense | 2.65 | 0.923 |
| Malpractice | 0.22 | 0.378 |
(3.57 × 1 + 2.65 × 0.923 + 0.22 × 0.378) × $33.4009 = $203.72
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.57 | 1 |
| Practice expense | 2.65 | 0.923 |
| Malpractice | 0.22 | 0.378 |
(3.57 × 1 + 2.65 × 0.923 + 0.22 × 0.378) × $33.4009 = $203.72
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
90962 billing questions
When is 90962 selected instead of 90961 or 90960?
Use 90962 for an eligible patient age 20 or older when there is one qualifying visit in the month. The other codes in this group correspond to two or three visits, or four or more visits.
Does 90962 represent each dialysis treatment?
No. It represents the monthly ESRD-related management level, not a per-session service. Do not count each dialysis treatment as a separate unit of 90962.
Can 90962 be used for a patient receiving home dialysis?
The home-dialysis monthly series has separate codes, including 90966 for patients age 20 or older. Choose the code that matches the patient’s dialysis setting and monthly circumstances.
What documentation supports the one-visit level?
Document the date and substance of the qualifying visit, the patient’s ESRD-related assessment and management, and the care coordination performed. The record should also support the patient’s age and dialysis circumstances.
What if monthly ESRD care covers only part of the month?
The per-day ESRD service series may be relevant when care is provided for only part of a month. For a patient age 20 or older, compare the circumstances with 90970.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
11,57290959,,Esrd serv 1 vst p mo 12-19,A,,6.19,3.57,,3.57,,0.39,10.15,10.15,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,57390960,,Esrd srv 4 visits p mo 20+,A,,6.77,3.96,,3.96,,0.43,11.16,11.16,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,57490961,,Esrd srv 2-3 vsts p mo 20+,A,,5.52,3.42,,3.42,,0.36,9.30,9.30,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,57590962,,Esrd serv 1 visit p mo 20+,A,,3.57,2.65,,2.65,,0.22,6.44,6.44,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,57690963,,Esrd home pt serv p mo <2yrs,A,,12.09,5.91,,5.91,,0.75,18.75,18.75,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,57790964,,Esrd home pt serv p mo 2-11,A,,10.25,5.12,,5.12,,0.62,15.99,15.99,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,57890965,,Esrd home pt serv p mo 12-19,A,,9.80,5.05,,5.05,,0.60,15.45,15.45,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068