# CPT 90966

> Medicare paid $240.60 for CPT 90966 in the office (non-facility) setting and $240.60 in a facility under the Q3 2016 Physician Fee Schedule, effective July 2016. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2016, when it decreased 0.2%.

## What it is

A full calendar month of overseeing an adult who does dialysis at home, whether peritoneal dialysis or home hemodialysis. The work includes reviewing the patient's records and home logs, adjusting the dialysis prescription, tracking labs, managing blood pressure, anemia and fluid balance, and troubleshooting the catheter or home equipment. Unlike the in-center codes, this one is not sorted by how many face-to-face visits happened; it covers a complete month of home-dialysis oversight for a patient aged twenty or older. Companion codes cover home dialysis in children and partial months when the patient starts, stops, or is hospitalised mid-month.

## Selected release

- Release: Q3 2016 (2016 C)
- Effective: July 1 – September 30, 2016
- Status indicator: A
- Office (non-facility) national allowed amount: $240.60
- Facility national allowed amount: $240.60
- Sequestration: not applied

## RVUs and formula

- Work RVU: 4.26
- Office (non-facility) practice expense RVU: 2.22
- Facility practice expense RVU: 2.22
- Malpractice RVU: 0.24
- Conversion factor: 35.8043
- Formula: `(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor`

## Source and citation

- Source: Physician relative value file (Q3 2016)
- CMS file: https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu16c.zip
- Parsed file: PPRRVU16_V0517.csv, row 14,850
- Canonical page: https://localishealth.com/cpt/90966/2016/A
- Release-specific citation URL: https://localishealth.com/cpt/90966/2016/C
- Last significant update: 2026-08-04T03:06:56+00:00