go back

Monthly Kidney Care Management, Limited In-Person Visits

West Virginia rates for HCPCS 90962

A physician or other clinician provides ongoing monthly management of a patient's kidney-related care, including reviewing overall health status and coordinating treatment, for a month in which the patient was seen in person less often than the standard full monthly bundle of visits. This covers the physician's oversight work for that month rather than the dialysis treatments themselves. It applies to adult patients receiving this type of outpatient kidney disease management.

Rates data updated July 2026.

How much does Monthly Kidney Care Management, Limited In-Person Visits cost?

$195

Typical negotiated rate. In West Virginia, July 2026.

Insurers have agreed to pay about $195 for this service. The price depends on where it is billed: about $195 from a physician practice, and about $355 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$195$191 to $240
FacilityA hospital or hospital-owned outpatient department$355$257 to $355

How much rates vary

Facilitymedian $355 · 10th to 90th $214 to $355Professionalmedian $195 · 10th to 90th $162 to $437
$200$500facility $355professional $195

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$194.98
Typical High
$436.52
CareSource
Setting
Facility
Modifier
Global
Typical Low
$213.80
Median
$213.80
Typical High
$257.04
CareSource
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$223.87
Typical High
$223.87
Cigna
Setting
Facility
Modifier
Global
Typical Low
$354.81
Median
$354.81
Typical High
$354.81
Cigna
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$245.47
Typical High
$1,047.13
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$245.47
Typical High
$380.19
United
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$154.88
Typical High
$154.88
United
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$190.55
Typical High
$281.84

Where West Virginia sits

The same service costs 2.1 times more in Minnesota than in Vermont. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

West Virginia· 43rd of 51

$195

MN $372VT $178

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.