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See a sample rate comparisonCPT 90999 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Dialysis For Kidney Failure, Treatment For Kidney Failure In Which Waste Materials Are Removed From The Blood By Passing The Blood Through A Machine Which Filters The Blood (Dialysis).
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Dialysis Services and Procedures |
| Common Place of Service | 99 - Other POS 21 - Inpatient Hospital |
| Common Modifiers | V7 - Arteriovenous fistula G5 - Most recent URR reading of 75 or greater |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 90999 |
| Medicaid Fee Schedule | $145.13 median of the 3 states in the free preview · View Medicaid rates for 90999 |
National average reimbursement for CPT 90999 by major payers:
$572.49
$144.77
$814.24
$408.47
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CPT 90999
5 of 25 sample ratesHigher to lower in this preview
Ram Balasubramanian
$68.73Published rateRestorative Health Rehabilitation Inc
$55.00Published rateAll Ways Homecare Inc
$40.00Published rateBrian Dearing
Cardiology Associates Of Mobile, Inc.
$39.00Published rateRestorative Health Rehabilitation Inc
$35.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 90999 vs. Other Dialysis Services and Procedures Codes
The CPT 90999 code is part of the Medicine Services and Procedures services used for Dialysis Services and Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 90999 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 90989-CPT | Moderate | Training For Dialysis In Home, In-Home Training In The Use Of Equipment For Performing Dialysis. Dialysis Filters Waste From The Blood When The Kidneys No Longer Are Able To Perform That Function. |
| 90993-CPT | Low | Training For Dialysis In Home, In-Home Training In The Use Of Equipment For Performing Dialysis. Dialysis Filters Waste From The Blood When The Kidneys No Longer Are Able To Perform That Function. |
| 90997-CPT | Low | Hemoperfusion (Eg With Activa, Hemoperfusion (Eg With Activated Charcoal Or Resin)Hemoperfusion (Eg With Activated Charcoal Or Resin) |
| 90999-CPT | Moderate | Dialysis For Kidney Failure, Treatment For Kidney Failure In Which Waste Materials Are Removed From The Blood By Passing The Blood Through A Machine Which Filters The Blood (Dialysis). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90999. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90999 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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Frequently Asked Questions
To find the cost of a specific medical procedure or service, it's best to look up the fee schedule using the CPT (Current Procedural Terminology) code and your specific location. For an accurate estimate tailored to your situation, you can use a tool like Payerprice, which offers a fee schedule lookup based on CPT code and location. You can also contact your insurance provider or the healthcare facility directly for a personalized quote.
A CPT (Current Procedural Terminology) code is a five-digit numerical code used by healthcare providers to describe medical, surgical, and diagnostic services. These codes are essential for accurate billing and record-keeping, allowing for standardized communication about medical procedures between providers, payers, and patients. When looking up costs, using the specific CPT code helps ensure you are getting pricing for the exact service you need.
Healthcare prices can vary significantly due to a multitude of factors, including geographic location, the specific healthcare provider or facility, insurance contracts, negotiation power between providers and payers, and whether the service is in-network or out-of-network. Different payers (insurance companies) also have different negotiated rates for the same services, leading to a wide range of prices even for identical procedures.
A fee schedule lists the maximum amounts that a health plan will pay for healthcare services. While some general information might be publicly available, specific fee schedules are often proprietary agreements between insurance companies and providers. For consumers looking to understand the cost of a service based on CPT code and location for their specific situation, tools like Payerprice offer fee schedule lookup capabilities.
CMS (Centers for Medicare & Medicaid Services) provides fee schedules for Medicare and Medicaid services, which are government programs. While CMS data can offer a baseline, it might not directly reflect the prices for privately insured individuals or specific commercial payer rates. Payerprice, on the other hand, offers a fee schedule lookup tool designed for users to search with CPT codes and specific locations, potentially providing more relevant information for a broader range of insurance plans and private payer rates, making it suitable for finding answers based on your specific situation.