CPT 90970

Across 260,008 services billed by 629 providers to 13,027 beneficiaries, Medicare allowed an average of $9.13 per service. That is 20.0 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.

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.

• 90960Dialysis services$347.78
• 90935Hemodialysis procedure$68.67
• 90961Dialysis services$286.31
• 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
• 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

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.

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