{
    "code": "90960",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/90960/2018/A",
    "release_specific_url": "https://localishealth.com/cpt/90960/2018/A",
    "description": "A full calendar month of managing an adult with end-stage renal disease on dialysis, where the physician or advanced practitioner saw the patient face to face four or more times during that month. The month of care covers reviewing lab results, adjusting the dialysis prescription and dry weight, managing anemia, blood pressure, bone and mineral problems, nutrition, and access to the bloodstream. Two sibling codes cover the same adult population at lower visit frequencies: two to three visits, or a single visit. Other codes in the family cover children, where the bands are defined by age instead.",
    "answer": {
        "question": "How much did Medicare pay for CPT 90960 in Q1 2018?",
        "text": "Medicare paid $288.36 for CPT 90960 in the office (non-facility) setting and $288.36 in a facility under the Q1 2018 Physician Fee Schedule, effective January 2018. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This is a 0.4% increase from the previous quarter."
    },
    "release": {
        "schedule": "pfs",
        "year": 2018,
        "quarter": "A",
        "label": "Q1 2018",
        "effective": "January 1 – March 31, 2018",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 288.36,
        "facility": 288.36,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 5.18,
        "practice_expense_non_facility": 2.54,
        "practice_expense_facility": 2.54,
        "malpractice": 0.29
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 35.9996,
    "source": {
        "label": "Physician relative value file (Q1 2018)",
        "cms_url": "https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu18ar1.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2018/A",
        "file": "PPRRVU18_JAN.csv",
        "row": 15149,
        "sha256": "b2c0cf1c065aa6f715438573eb2251381843a90991cf56818aaf33301c43c932"
    },
    "modified_at": "2026-08-04T03:08:09+00:00"
}