$366.28–$410.13
90960 represents a full month of ESRD-related services for a patient age 20 or older with four or more face-to-face visits; 90970 is for a partial month and is reported by day.
On this page
CMS RVU26D · Effective 2026-10-01
90970 ESRD services Medicare reimbursement rates in Virginia
Reports a physician’s ESRD-related services by day for a patient age 20 or older whose care spans less than a full month. Compare 90970 office and facility rates across CMS payment localities in Virginia.
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 90970 in Virginia?
Virginia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$9.86–$11.04
2 of 2 localities have a supported rate.
Facility setting
$9.86–$11.04
2 of 2 localities have a supported rate.
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 90970: Partial-month ESRD services, age 20 or older
Reports a physician’s ESRD-related services by day for a patient age 20 or older whose care spans less than a full month.
This code represents physician services related to end-stage renal disease for a patient age 20 or older during a period shorter than a full month. A nephrologist commonly reports it when the patient’s ESRD care begins or ends partway through the month, or when care shifts between providers. Services may occur in a dialysis facility, hospital, or other setting where the physician manages the patient’s ESRD care.
Report the code by day for the partial-month period, rather than selecting a monthly ESRD service code based on visit count. Documentation should support the patient’s age, dates of ESRD-related physician care, the partial-month service period, and the management performed. The service concerns physician ESRD care, not a dialysis treatment procedure such as a single dialysis evaluation. Medicare Physician Fee Schedule payment is based on the per-day service represented by this code.
Where the value comes from
- Work RVU0.18 · 60%
- Practice expense (office) RVU0.11 · 37%
- Malpractice RVU0.01 · 3%
463.8K
Medicare services in 2024 · #238 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.
90970 compared with similar codes
Office rates for Virginia, from the same CMS release.
$305.15–$342.28
90961 represents a full month for a patient age 20 or older with two or three face-to-face visits. Use 90970 for a less-than-full-month service period.
$211.44–$238.13
90962 represents a full month for a patient age 20 or older with one face-to-face visit; 90970 describes per-day care in a partial month.
No office rate
90945 is a dialysis service with one evaluation, rather than per-day physician management of ESRD during a partial month.
Compare 90970 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.
2 of 2 payment localities
Dc + Md/Va Suburbs →
Office / nonfacility
$11.04
Facility
$11.04
Virginia →
Office / nonfacility
$9.86
Facility
$9.86
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90970 billing questions
When should this code be used instead of 90960, 90961, or 90962?
Use 90970 when ESRD-related services cover less than a full month for a patient age 20 or older. The monthly codes represent a full month of service and are selected according to the number of face-to-face visits.
Is the code reported per day or per dialysis treatment?
It is a per-day code for ESRD-related physician services during a partial month. A dialysis treatment session is not, by itself, the unit described by this code.
What documentation supports reporting 90970?
Record the patient’s age, dates of service, why the ESRD service period was shorter than a full month, and the physician’s ESRD-related management.
Does this code represent the dialysis treatment itself?
No. It represents the physician’s ESRD-related care. Codes such as 90945 and 90947 describe dialysis services with evaluation and are distinct services.
Which age group does 90970 cover?
It is for patients age 20 or older. The related per-day codes 90967, 90968, and 90969 cover younger age groups.
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.
11,58090967,,Esrd svc pr day pt <2,A,,0.35,0.18,,0.18,,0.02,0.55,0.55,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,58190968,,Esrd svc pr day pt 2-11,A,,0.34,0.17,,0.17,,0.02,0.53,0.53,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,58290969,,Esrd svc pr day pt 12-19,A,,0.33,0.17,,0.17,,0.02,0.52,0.52,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,58390970,,Esrd svc pr day pt 20+,A,,0.18,0.11,,0.11,,0.01,0.30,0.30,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,58490989,,Dialysis training complete,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
11,58590993,,Dialysis training incompl,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
11,58690997,,Hemoperfusion,A,,1.79,0.38,NA,0.38,,0.11,2.28,2.28,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00