# CPT 90960

> Medicare paid $362.54 for CPT 90960 in the office (non-facility) setting and $362.54 in a facility under the Q1 2021 Physician Fee Schedule, effective January 2021. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This is a 24.5% increase from the previous quarter.

## What it is

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.

## Selected release

- Release: Q1 2021 (2021 A)
- Effective: January 1 – March 31, 2021
- Status indicator: A
- Office (non-facility) national allowed amount: $362.54
- Facility national allowed amount: $362.54
- Sequestration: not applied

## RVUs and formula

- Work RVU: 6.77
- Office (non-facility) practice expense RVU: 3.20
- Facility practice expense RVU: 3.20
- Malpractice RVU: 0.42
- Conversion factor: 34.8931
- Formula: `(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor`

## Source and citation

- Source: Physician relative value file (Q1 2021)
- CMS file: https://www.cms.gov/files/zip/rvu21a-updated-01052021.zip
- Parsed file: PPRRVU21_JAN.csv, row 15,785
- Canonical page: https://localishealth.com/cpt/90960/2021/A
- Release-specific citation URL: https://localishealth.com/cpt/90960/2021/A
- Last significant update: 2026-08-04T03:10:16+00:00