Nephrology · CMS status A
90960
ESRD service mo adult 4 visits
End-stage renal disease related services, monthly, for patients 20 years and older, with 4 or more face-to-face visits per month.
Work RVU
4.30
2026 Medicare pays
$200.74
National GPCI · non-facility · CF $33.4009
RVU anatomyWork 4.30 + Practice 1.39 + Malpractice 0.32 = 6.01 total
Work (your effort)Practice expenseMalpractice
When to use it
Adult ESRD patient on chronic dialysis, 4+ face-to-face visits in the calendar month.
Documentation checklist
- ✓Each of the 4+ face-to-face dialysis visits documented with date and content.
- ✓Monthly assessment of fluid/electrolyte status, dialysis adequacy, access, anemia, bone disease, nutrition.
Common pitfalls
- !Cannot bill separate E/M for ESRD care that month.
- !Visits must be face-to-face — telehealth has different rules per payer.
Common ICD-10 pairings
N18.6
Educational reference, not billing or legal advice. Verify against your payer contracts and your compliance team before submission.