How much does Medicare pay for CPT 90913?

Medicare allowed an average of $30.27 per service and paid $23.67 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $69.97, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 90913?

Biofeedback training for bowel or bladder control, each additional 15 minutes. It was billed 25,281 times to 2,794 Medicare beneficiaries by 95 providers in 2024.

Does 90913 pay differently in an office than a hospital?

Yes. The allowed amount averaged $30.96 in an office setting and $22.45 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 90913 most?

Obstetrics & Gynecology, with 17,711 services from 15 clinicians. Next are Physical Therapist in Private Practice, Gastroenterology, Nurse Practitioner.

CPT 90913

Biofeedback training for bowel or bladder control, each additional 15 minutes

$30.27Medicare-allowed amount per service, averaged across 25,281 services

Providers submitted

$69.97

Asking price, not received

Medicare allowed

$30.27

The fee schedule figure

Medicare paid

$23.67

Balance is patient coinsurance

Providers submitted an average of $69.97 for this code and Medicare allowed $30.27 — 2.3× 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 $23.67 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $30.96
Hospital / facility: $22.45

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. 23,211 services were billed in an office setting and 2,070 in a facility.

Services: 25,281
Beneficiaries: 2,794
Providers billing it: 95
Total allowed: $765,256

What Medicare pays for CPT 90913

Across 25,281 services billed by 95 providers to 2,794 beneficiaries, Medicare allowed an average of $30.27 per service. That is 9.0 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 90913

Specialty	Services	Beneficiaries	Avg allowed	Providers
Obstetrics & Gynecology	17,711	729	$30.94	15
Physical Therapist in Private Practice	3,793	1,035	$31.02	38
Gastroenterology	1,381	288	$26.08	12
Nurse Practitioner	1,025	299	$24.68	11
Internal Medicine	410	117	$28.88	4
Urology	389	119	$31.48	7
Physician Assistant	374	143	$21.09	5
General Surgery	102	28	$29.76	1
Colorectal Surgery (Proctology)	69	18	$35.48	1
Radiation Oncology	27	18	$25.33	1

90913 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	16,074	$30.84	$24.58	3
Florida	3,046	$30.53	$23.72	21
California	1,117	$31.06	$21.71	16
Georgia	666	$24.95	$19.57	4
Delaware	638	$30.07	$23.12	5
Maryland	591	$28.35	$20.12	8
New York	582	$31.56	$22.65	7
Missouri	511	$19.56	$14.76	4
Pennsylvania	462	$31.25	$24.35	5
Iowa	429	$26.32	$21.26	4
Texas	291	$29.80	$24.46	3
Minnesota	234	$29.57	$22.38	4
North Carolina	126	$30.41	$23.67	3
Virginia	119	$30.25	$24.43	3
Nevada	113	$31.52	$25.05	1
West Virginia	102	$29.76	$22.61	1
Alabama	64	$30.01	$25.05	1
Ohio	62	$30.16	$24.23	1
New Jersey	54	$31.42	$24.30	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
90912Biofeedback training for bowel or bladder control$74.05
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.