How much does Medicare pay for CPT 90912?

Medicare allowed an average of $74.05 per service and paid $57.09 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $157.21, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 90912?

Biofeedback training for bowel or bladder control, initial 15 minutes. It was billed 22,725 times to 5,395 Medicare beneficiaries by 189 providers in 2024.

Does 90912 pay differently in an office than a hospital?

Yes. The allowed amount averaged $76.58 in an office setting and $38.97 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 90912 most?

Obstetrics & Gynecology, with 9,047 services from 20 clinicians. Next are Physical Therapist in Private Practice, Nurse Practitioner, Urology.

CPT 90912

Biofeedback training for bowel or bladder control, initial 15 minutes

$74.05Medicare-allowed amount per service, averaged across 22,725 services

Providers submitted

$157.21

Asking price, not received

Medicare allowed

$74.05

The fee schedule figure

Medicare paid

$57.09

Balance is patient coinsurance

Providers submitted an average of $157.21 for this code and Medicare allowed $74.05 — 2.1× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $57.09 (77%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $76.58
Hospital / facility: $38.97

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 21,200 services were billed in an office setting and 1,525 in a facility.

Services: 22,725
Beneficiaries: 5,395
Providers billing it: 189
Total allowed: $1,682,786

What Medicare pays for CPT 90912

Across 22,725 services billed by 189 providers to 5,395 beneficiaries, Medicare allowed an average of $74.05 per service. That is 4.2 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 90912

Specialty	Services	Beneficiaries	Avg allowed	Providers
Obstetrics & Gynecology	9,047	927	$78.67	20
Physical Therapist in Private Practice	7,962	2,254	$75.78	78
Nurse Practitioner	2,219	735	$58.70	23
Urology	1,201	477	$81.17	24
Gastroenterology	780	392	$53.97	18
Physician Assistant	658	286	$51.53	12
Internal Medicine	229	117	$67.89	4
General Surgery	218	34	$72.61	1
Occupational Therapist in Private Practice	198	55	$79.53	4
Colorectal Surgery (Proctology)	102	31	$81.76	2
Family Practice	91	67	$84.68	2
Radiation Oncology	20	20	$44.96	1

90912 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Arizona	7,583	$77.56	$60.90	11
Florida	4,029	$74.72	$59.60	37
California	1,578	$67.67	$47.07	26
Pennsylvania	1,570	$75.14	$59.54	15
Texas	1,558	$69.27	$54.31	14
Maryland	1,145	$83.06	$57.75	10
New York	868	$79.91	$58.16	14
Delaware	615	$76.92	$57.55	6
Missouri	602	$41.57	$31.40	5
Oklahoma	408	$73.53	$58.36	1
Georgia	377	$54.31	$47.25	4
Iowa	372	$66.98	$54.21	4
New Jersey	284	$80.23	$58.70	6
Colorado	224	$75.65	$57.10	3
West Virginia	218	$72.61	$58.47	1
North Carolina	217	$68.54	$53.09	8
Minnesota	194	$74.22	$53.97	4
Ohio	154	$62.12	$57.67	4
Virginia	145	$76.47	$61.33	4
Michigan	127	$78.16	$64.14	2
Wisconsin	114	$75.51	$62.60	1
Nevada	113	$79.58	$63.16	1
Washington	98	$60.26	$61.55	2
Nebraska	44	$73.30	$60.57	2
Alabama	32	$74.29	$63.16	1
Oregon	27	$82.89	$62.04	1
Kansas	15	$73.78	$43.78	1
Louisiana	14	$72.81	$62.57	1

Related codes

90960Dialysis services$347.78
90935Hemodialysis procedure$68.67
90961Dialysis services$286.31
90970Dialysis services$9.13
90966Home dialysis services per month (20 years or older)$281.93
90901Biofeedback training$40.14
90962Dialysis services$199.48
90945Dialysis procedure including 1 evaluation$83.22
90913Biofeedback training for bowel or bladder control$30.27
90937Hemodialysis procedure requiring repeated evaluation$102.75
90947Dialysis procedure requiring repeat evaluation$118.72
90999Other inpatient or outpatient dialysis procedure$107.25

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.