$379.27–$411.46
Both are monthly ESRD management codes for patients age 20 or older. Choose 90960 when the month includes four or more face-to-face visits; 90961 is for two or three.
On this page
CMS RVU26D · Effective 2026-10-01
90961 ESRD management Medicare reimbursement rates in Washington
Monthly ESRD management for patients age 20 or older, reported when the physician provides two or three face-to-face visits during the month. Compare 90961 office and facility rates across CMS payment localities in Washington.
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 90961 in Washington?
Washington 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
$316.21–$343.58
2 of 2 localities have a supported rate.
Facility setting
$316.21–$343.58
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.
ESRD management
About 90961: Monthly ESRD management, 2-3 visits
Monthly ESRD management for patients age 20 or older, reported when the physician provides two or three face-to-face visits during the month.
This code represents a month of ongoing management for an adult with end-stage renal disease receiving dialysis. A nephrologist or other physician overseeing the patient’s ESRD care may assess dialysis adequacy, fluid status, anemia, mineral and bone disease, medications, vascular access, and related treatment needs. The work may occur in the context of outpatient dialysis care and includes the physician’s continuing management across the month, not just a single dialysis treatment.
Select this monthly level for a patient age 20 or older when the physician provides two or three face-to-face visits during the month. The visit count, dates, age, and documented ESRD management support the level reported. Do not count dialysis sessions as physician visits. The adjacent monthly levels distinguish patients with four or more visits from those with one visit; separate home-dialysis and per-day codes describe different circumstances.
Where the value comes from
- Work RVU5.52 · 59%
- Practice expense (office) RVU3.42 · 37%
- Malpractice RVU0.36 · 4%
393K
Medicare services in 2024 · #260 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.
90961 compared with similar codes
Office rates for Washington, from the same CMS release.
$219.59–$239.81
90962 is the one-visit monthly level for patients age 20 or older. 90961 requires two or three face-to-face visits during the month.
$315.85–$343.17
90966 describes monthly ESRD services for an adult receiving home dialysis. 90961 uses the two-to-three-visit monthly level for its patient category.
$10.21–$11.09
90970 reports ESRD services per day for patients age 20 or older; 90961 represents monthly management when two or three face-to-face visits occur.
Compare 90961 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
Rest Of Washington →
Office / nonfacility
$316.21
Facility
$316.21
Seattle (King Cnty) →
Office / nonfacility
$343.58
Facility
$343.58
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90961 billing questions
How does 90961 differ from 90960 and 90962?
For patients age 20 or older, 90961 represents two or three face-to-face visits in the month. Use 90960 for four or more visits and 90962 for one visit.
Are dialysis sessions counted as visits?
No. The level is based on the physician’s face-to-face visits with the patient during the month, not the number of dialysis treatments.
What documentation supports reporting 90961?
Record the patient’s age, the dates of the two or three face-to-face visits, and the ESRD management addressed during the month.
Is 90961 reported once per visit?
No. It represents monthly ESRD management at the two-to-three-visit level, rather than a separate unit for each visit.
How does 90961 differ from 90966?
90961 is selected by the monthly face-to-face visit count for an adult patient. 90966 describes monthly ESRD services for an adult receiving home dialysis.
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.
11,57190958,,Esrd srv 2-3 vsts p mo 12-19,A,,9.87,5.05,,5.05,,0.61,15.53,15.53,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,57290959,,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