When should I use 90970?

Per-diem ESRD billing when patient is not on chronic dialysis for the full month (e.g. transplant, hospitalization, death).

What documentation does 90970 require?

- Date(s) of ESRD service. - Reason monthly MCP doesn't apply.

What are common 90970 billing pitfalls?

- Cannot stack with 90960-90962 in the same month.

How much does 90970 pay in 2026?

2026 work RVU for 90970 is 0.10. National Medicare non-facility allowable is approximately $6.01 at the 2026 conversion factor. Adjust for locality GPCI and your payer's contracted conversion factor for actual payment.

Nephrology · CMS status A

90970

ESRD MCP per diem, 20+yr

ESRD related services per day, age 20+ years.

Nephro

Model in calculator →Audit a note

Work RVU

0.10

2026 Medicare pays

$6.01

National GPCI · non-facility · CF $33.4009

RVU anatomyWork 0.10 + Practice 0.07 + Malpractice 0.01 = 0.18 total

Work (your effort)Practice expenseMalpractice

When to use it

Per-diem ESRD billing when patient is not on chronic dialysis for the full month (e.g.

Full guidance

transplant, hospitalization, death).

Documentation checklist

✓Date(s) of ESRD service.
✓Reason monthly MCP doesn't apply.

Common pitfalls

!Cannot stack with 90960-90962 in the same month.

Common ICD-10 pairings

N18.6

Educational reference, not billing or legal advice. Verify against your payer contracts and your compliance team before submission.