CPT code 90951: ESRD monthly care, under 2 years, 4+ visits2026 Medicare rate & RVUs in Iowa
Monthly ESRD management for a patient younger than 2 years, reported when the physician or qualified professional provides at least four face-to-face visits.
In Iowa, Medicare pays $1,125.76 for 90951 in the office and $1,125.76 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 90951 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 90951 covers
CPT 90951 represents a month of ongoing end-stage renal disease management for a child younger than 2 years who receives at least four face-to-face visits from a physician or other qualified health care professional during that month. A nephrologist commonly provides this care in connection with dialysis, assessing matters such as the dialysis plan, fluid status, vascular access, laboratory findings, and related complications. The service is distinct from documenting a single dialysis treatment encounter.
Choose the monthly code using both the patient’s age category and the number of face-to-face visits in the month. The record should support the visits and the ESRD-related assessment and management provided; report the service for the month, not as one unit for each visit. For a patient receiving home dialysis, compare the home-dialysis monthly family, 90963–90966. When management covers only part of a month, compare the age-specific daily service family, 90967–90970.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
How Iowa compares for 90951
Across 109 of 109 payment localities, the office rate for 90951 runs from $1,112.70 in Arkansas to $1,583.15 in Alaska. Iowa pays $1,125.76. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Iowa · this page$1,125.76
- Los Angeles, CA · California$1,261.59+$135.83
- Washington, DC area · District of Columbia$1,292.19+$166.43
- Miami, FL · Florida$1,272.07+$146.31
- Chicago, IL · Illinois$1,254.15+$128.39
- Manhattan, NY · New York$1,317.87+$192.11
- Alaska · Alaska$1,583.15+$457.39
Other areas in Iowa first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $1,120.56 | $1,120.56 |
| ArkansasArkansas | $1,112.70 | $1,112.70 |
| ArizonaArizona | $1,166.29 | $1,166.29 |
| Bakersfield, CACalifornia | $1,212.10 | $1,212.10 |
| Chico, CACalifornia | $1,206.94 | $1,206.94 |
| El Centro, CACalifornia | $1,207.18 | $1,207.18 |
| Fresno, CACalifornia | $1,206.94 | $1,206.94 |
| Hanford, CACalifornia | $1,206.94 | $1,206.94 |
| Madera, CACalifornia | $1,206.94 | $1,206.94 |
| Merced, CACalifornia | $1,206.94 | $1,206.94 |
| Modesto, CACalifornia | $1,206.94 | $1,206.94 |
| Napa, CACalifornia | $1,316.92 | $1,316.92 |
| Oxnard, CACalifornia | $1,248.87 | $1,248.87 |
| Redding, CACalifornia | $1,206.94 | $1,206.94 |
| Rest of CaliforniaCalifornia | $1,206.94 | $1,206.94 |
| Riverside, CACalifornia | $1,223.20 | $1,223.20 |
| Sacramento, CACalifornia | $1,244.63 | $1,244.63 |
| Salinas, CACalifornia | $1,239.29 | $1,239.29 |
| San Diego, CACalifornia | $1,251.22 | $1,251.22 |
| Marin County, CACalifornia | $1,371.01 | $1,371.01 |
| San Francisco, CACalifornia | $1,369.35 | $1,369.35 |
| San Benito County, CACalifornia | $1,397.50 | $1,397.50 |
| Santa Clara County, CACalifornia | $1,390.72 | $1,390.72 |
| San Luis Obispo, CACalifornia | $1,221.39 | $1,221.39 |
| Santa Cruz, CACalifornia | $1,250.12 | $1,250.12 |
| Santa Maria, CACalifornia | $1,239.25 | $1,239.25 |
| Santa Rosa, CACalifornia | $1,261.68 | $1,261.68 |
| Stockton, CACalifornia | $1,206.94 | $1,206.94 |
| Vallejo, CACalifornia | $1,314.53 | $1,314.53 |
| Visalia, CACalifornia | $1,206.94 | $1,206.94 |
| Yuba City, CACalifornia | $1,206.94 | $1,206.94 |
| ColoradoColorado | $1,204.14 | $1,204.14 |
| ConnecticutConnecticut | $1,235.82 | $1,235.82 |
| DelawareDelaware | $1,178.77 | $1,178.77 |
| Fort Lauderdale, FLFlorida | $1,227.50 | $1,227.50 |
| Rest of FloridaFlorida | $1,193.47 | $1,193.47 |
| Atlanta, GAGeorgia | $1,201.30 | $1,201.30 |
| Rest of GeorgiaGeorgia | $1,156.80 | $1,156.80 |
| Hawaii, Guam, HIHawaii | $1,209.23 | $1,209.23 |
| IdahoIdaho | $1,131.15 | $1,131.15 |
| East St. Louis, ILIllinois | $1,206.29 | $1,206.29 |
| Rest of IllinoisIllinois | $1,181.95 | $1,181.95 |
| Suburban Chicago, ILIllinois | $1,236.04 | $1,236.04 |
| IndianaIndiana | $1,134.13 | $1,134.13 |
| KansasKansas | $1,127.28 | $1,127.28 |
| KentuckyKentucky | $1,142.29 | $1,142.29 |
| New Orleans, LALouisiana | $1,170.54 | $1,170.54 |
| Rest of LouisianaLouisiana | $1,143.04 | $1,143.04 |
| Metropolitan Boston, MAMassachusetts | $1,276.31 | $1,276.31 |
| Rest of MassachusettsMassachusetts | $1,204.42 | $1,204.42 |
| Baltimore area, MDMaryland | $1,232.60 | $1,232.60 |
| Rest of MarylandMaryland | $1,191.75 | $1,191.75 |
| Rest of MaineMaine | $1,138.41 | $1,138.41 |
| Southern Maine, MEMaine | $1,162.71 | $1,162.71 |
| Detroit, MIMichigan | $1,205.42 | $1,205.42 |
| Rest of MichiganMichigan | $1,160.79 | $1,160.79 |
| MinnesotaMinnesota | $1,159.14 | $1,159.14 |
| Metropolitan Kansas City, MOMissouri | $1,162.11 | $1,162.11 |
| Metropolitan St. Louis, MOMissouri | $1,167.70 | $1,167.70 |
| Rest of MissouriMissouri | $1,136.09 | $1,136.09 |
| MississippiMississippi | $1,124.29 | $1,124.29 |
| MontanaMontana | $1,183.63 | $1,183.63 |
| North CarolinaNorth Carolina | $1,143.61 | $1,143.61 |
| North DakotaNorth Dakota | $1,154.76 | $1,154.76 |
| NebraskaNebraska | $1,127.52 | $1,127.52 |
| New HampshireNew Hampshire | $1,191.41 | $1,191.41 |
| Northern New JerseyNew Jersey | $1,291.14 | $1,291.14 |
| Rest of New JerseyNew Jersey | $1,251.33 | $1,251.33 |
| New MexicoNew Mexico | $1,165.64 | $1,165.64 |
| NevadaNevada | $1,175.92 | $1,175.92 |
| NYC suburbs and Long Island, NYNew York | $1,340.16 | $1,340.16 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $1,261.84 | $1,261.84 |
| Queens, NYNew York | $1,317.57 | $1,317.57 |
| Rest of New YorkNew York | $1,152.44 | $1,152.44 |
| OhioOhio | $1,154.88 | $1,154.88 |
| OklahomaOklahoma | $1,136.90 | $1,136.90 |
| Portland, OROregon | $1,221.32 | $1,221.32 |
| Rest of OregonOregon | $1,167.90 | $1,167.90 |
| Metropolitan Philadelphia, PAPennsylvania | $1,221.30 | $1,221.30 |
| Rest of PennsylvaniaPennsylvania | $1,153.49 | $1,153.49 |
| Puerto RicoPuerto Rico | $1,186.69 | $1,186.69 |
| Rhode IslandRhode Island | $1,204.73 | $1,204.73 |
| South CarolinaSouth Carolina | $1,150.88 | $1,150.88 |
| South DakotaSouth Dakota | $1,151.35 | $1,151.35 |
| TennesseeTennessee | $1,130.57 | $1,130.57 |
| Austin, TXTexas | $1,199.26 | $1,199.26 |
| Beaumont, TXTexas | $1,150.02 | $1,150.02 |
| Brazoria, TXTexas | $1,176.37 | $1,176.37 |
| Dallas, TXTexas | $1,182.65 | $1,182.65 |
| Fort Worth, TXTexas | $1,179.92 | $1,179.92 |
| Galveston, TXTexas | $1,179.38 | $1,179.38 |
| Houston, TXTexas | $1,206.10 | $1,206.10 |
| Rest of TexasTexas | $1,161.86 | $1,161.86 |
| UtahUtah | $1,158.59 | $1,158.59 |
| VirginiaVirginia | $1,163.68 | $1,163.68 |
| Virgin Islands, VIUnited States Virgin Islands | $1,186.69 | $1,186.69 |
| VermontVermont | $1,156.28 | $1,156.28 |
| Rest of WashingtonWashington | $1,200.27 | $1,200.27 |
| King County, WAWashington | $1,291.03 | $1,291.03 |
| WisconsinWisconsin | $1,135.87 | $1,135.87 |
| West VirginiaWest Virginia | $1,160.73 | $1,160.73 |
| WyomingWyoming | $1,171.05 | $1,171.05 |
90951 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$1,112.70
$1,583.15
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $1,583.15 | 1 |
| AL | $1,120.56 | 1 |
| AR | $1,112.70 | 1 |
| AZ | $1,166.29 | 1 |
| CA | $1,206.94–$1,397.50 | 29 |
| CO | $1,204.14 | 1 |
| CT | $1,235.82 | 1 |
| DC | $1,292.19 | 1 |
| DE | $1,178.77 | 1 |
| FL | $1,193.47–$1,272.07 | 3 |
| GA | $1,156.80–$1,201.30 | 2 |
| GU | $1,209.23 | 1 |
| HI | $1,209.23 | 1 |
| IA | $1,125.76 | 1 |
| ID | $1,131.15 | 1 |
| IL | $1,181.95–$1,254.15 | 4 |
| IN | $1,134.13 | 1 |
| KS | $1,127.28 | 1 |
| KY | $1,142.29 | 1 |
| LA | $1,143.04–$1,170.54 | 2 |
| MA | $1,204.42–$1,276.31 | 2 |
| MD | $1,191.75–$1,292.19 | 3 |
| ME | $1,138.41–$1,162.71 | 2 |
| MI | $1,160.79–$1,205.42 | 2 |
| MN | $1,159.14 | 1 |
| MO | $1,136.09–$1,167.70 | 3 |
| MS | $1,124.29 | 1 |
| MT | $1,183.63 | 1 |
| NC | $1,143.61 | 1 |
| ND | $1,154.76 | 1 |
| NE | $1,127.52 | 1 |
| NH | $1,191.41 | 1 |
| NJ | $1,251.33–$1,291.14 | 2 |
| NM | $1,165.64 | 1 |
| NV | $1,175.92 | 1 |
| NY | $1,152.44–$1,340.16 | 5 |
| OH | $1,154.88 | 1 |
| OK | $1,136.90 | 1 |
| OR | $1,167.90–$1,221.32 | 2 |
| PA | $1,153.49–$1,221.30 | 2 |
| PR | $1,186.69 | 1 |
| RI | $1,204.73 | 1 |
| SC | $1,150.88 | 1 |
| SD | $1,151.35 | 1 |
| TN | $1,130.57 | 1 |
| TX | $1,150.02–$1,206.10 | 8 |
| UT | $1,158.59 | 1 |
| VA | $1,163.68–$1,292.19 | 2 |
| VI | $1,186.69 | 1 |
| VT | $1,156.28 | 1 |
| WA | $1,200.27–$1,291.03 | 2 |
| WI | $1,135.87 | 1 |
| WV | $1,160.73 | 1 |
| WY | $1,171.05 | 1 |
How the 90951 rate is calculated
Each of 90951’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 90951
RVUs × geographic indexes × conversion factor
Work23.92
23.92 RVUs× 1.000 GPCI
Practice expense10.06
10.06 RVUs× 1.000 GPCI
Malpractice1.46
1.46 RVUs× 1.000 GPCI
Adjusted RVUs
35.4400
Conversion factor
$33.4009
Medicare rate
$1,183.73
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Iowa inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
11,564
- Code
- 90951
- Physician work
- 23.92
- Practice expense
- 10.06
- Malpractice
- 1.46
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 23.92 | × 1.000 | 23.9200 |
| Practice expense | 10.06 | × 0.915 | 9.2049 |
| Malpractice | 1.46 | × 0.397 | 0.5796 |
| Total RVUs | 33.7045 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Iowa$1125.76
Office: (23.92 × 1 + 10.06 × 0.915 + 1.46 × 0.397) × $33.4009 = $1125.76
Facility: (23.92 × 1 + 10.06 × 0.915 + 1.46 × 0.397) × $33.4009 = $1125.76
Payment rules and modifiers for 90951
90951 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · 90951
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$1,183.73
- Non-facility (office)
- $1,183.73
- Facility
- $1,183.73
Higher because the practice carries its own overhead.
How 90951 has changed in Iowa
90951 · Office / nonfacility
$1125.76
Effective 2026-10-01
The base rate is $60.82 higher than on 2025-10-01, moving from $1064.94 to $1125.76 (5.7%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$1064.94changed to$1125.76
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 9.04 changed to 10.06
- Malpractice RVU 1.64 changed to 1.46
- Practice expense GPCI 0.913 changed to 0.915
- Malpractice GPCI 0.457 changed to 0.397
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$1100.18changed to$1064.94
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 9.18 changed to 9.04
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$1082.22changed to$1100.18
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$1115.11changed to$1082.22
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 9.10 changed to 9.18
- Malpractice RVU 1.60 changed to 1.64
- Practice expense GPCI 0.910 changed to 0.913
- Malpractice GPCI 0.441 changed to 0.457
January 1, 2023
RVU23A
$1140.39changed to$1115.11
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 9.21 changed to 9.10
- Practice expense GPCI 0.907 changed to 0.910
- Malpractice GPCI 0.425 changed to 0.441
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$1138.66changed to$1140.39
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 8.88 changed to 9.21
- Malpractice RVU 1.55 changed to 1.60
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$912.09changed to$1138.66
- Conversion factor 36.0896 changed to 34.8931
- Work RVU 18.46 changed to 23.92
- Practice expense RVU 6.96 changed to 8.88
- Malpractice RVU 1.18 changed to 1.55
- Malpractice GPCI 0.424 changed to 0.425
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$911.76changed to$912.09
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 6.99 changed to 6.96
- Malpractice GPCI 0.423 changed to 0.424
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$912.89changed to$911.76
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 7.06 changed to 6.99
- Malpractice RVU 1.17 changed to 1.18
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$908.50changed to$912.89
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 7.01 changed to 7.06
- Malpractice RVU 1.16 changed to 1.17
- Practice expense GPCI 0.902 changed to 0.907
- Malpractice GPCI 0.458 changed to 0.423
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$904.00changed to$908.50
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 6.85 changed to 7.01
- Malpractice RVU 1.32 changed to 1.16
- Practice expense GPCI 0.896 changed to 0.902
- Malpractice GPCI 0.493 changed to 0.458
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$906.76changed to$904.00
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 6.95 changed to 6.85
- Malpractice RVU 1.11 changed to 1.32
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$902.25changed to$906.76
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$897.81changed to$902.25
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 6.88 changed to 6.95
- Malpractice RVU 0.98 changed to 1.11
- Practice expense GPCI 0.892 changed to 0.896
- Malpractice GPCI 0.475 changed to 0.493
Held through RVU15B.
January 1, 2014
RVU14A
$866.91changed to$897.81
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 7.39 changed to 6.88
- Malpractice RVU 1.02 changed to 0.98
- Practice expense GPCI 0.887 changed to 0.892
- Malpractice GPCI 0.456 changed to 0.475
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $866.91
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $1,125.76 | $1,125.76 | RVU26D |
| 2026-07-01 | $1,125.76 | $1,125.76 | RVU26C |
| 2026-04-01 | $1,125.76 | $1,125.76 | RVU26B |
| 2026-01-01 | $1,125.76 | $1,125.76 | RVU26A |
| 2025-10-01 | $1,064.94 | $1,064.94 | RVU25D |
| 2025-07-01 | $1,064.94 | $1,064.94 | RVU25C |
| 2025-04-01 | $1,064.94 | $1,064.94 | RVU25B |
| 2025-01-01 | $1,064.94 | $1,064.94 | RVU25A |
| 2024-10-01 | $1,100.18 | $1,100.18 | RVU24D |
| 2024-07-01 | $1,100.18 | $1,100.18 | RVU24C |
| 2024-04-01 | $1,100.18 | $1,100.18 | RVU24B |
| 2024-03-09 | $1,100.18 | $1,100.18 | RVU24AR |
| 2024-01-01 | $1,082.22 | $1,082.22 | RVU24A |
| 2023-10-01 | $1,115.11 | $1,115.11 | RVU23D |
| 2023-07-01 | $1,115.11 | $1,115.11 | RVU23C |
| 2023-04-01 | $1,115.11 | $1,115.11 | RVU23B |
| 2023-01-01 | $1,115.11 | $1,115.11 | RVU23A |
| 2022-10-01 | $1,140.39 | $1,140.39 | RVU22D |
| 2022-07-01 | $1,140.39 | $1,140.39 | RVU22C |
| 2022-04-01 | $1,140.39 | $1,140.39 | RVU22B |
| 2022-01-01 | $1,140.39 | $1,140.39 | RVU22A |
| 2021-10-01 | $1,138.66 | $1,138.66 | RVU21D |
| 2021-07-01 | $1,138.66 | $1,138.66 | RVU21C |
| 2021-04-01 | $1,138.66 | $1,138.66 | RVU21B |
| 2021-01-01 | $1,138.66 | $1,138.66 | RVU21A |
| 2020-10-01 | $912.09 | $912.09 | RVU20D |
| 2020-07-01 | $912.09 | $912.09 | RVU20C |
| 2020-04-01 | $912.09 | $912.09 | RVU20B |
| 2020-01-01 | $912.09 | $912.09 | RVU20A |
| 2019-10-01 | $911.76 | $911.76 | RVU19D |
| 2019-07-01 | $911.76 | $911.76 | RVU19C |
| 2019-04-01 | $911.76 | $911.76 | RVU19B |
| 2019-01-01 | $911.76 | $911.76 | RVU19A |
| 2018-10-01 | $912.89 | $912.89 | RVU18D |
| 2018-07-01 | $912.89 | $912.89 | RVU18C |
| 2018-04-01 | $912.89 | $912.89 | RVU18B |
| 2018-01-01 | $912.89 | $912.89 | RVU18AR1 |
| 2017-10-01 | $908.50 | $908.50 | RVU17D |
| 2017-07-01 | $908.50 | $908.50 | RVU17C |
| 2017-04-01 | $908.50 | $908.50 | RVU17B |
| 2017-01-01 | $908.50 | $908.50 | RVU17A |
| 2016-10-01 | $904.00 | $904.00 | RVU16D |
| 2016-07-01 | $904.00 | $904.00 | RVU16C |
| 2016-04-01 | $904.00 | $904.00 | RVU16B |
| 2016-01-01 | $904.00 | $904.00 | RVU16A |
| 2015-10-01 | $906.76 | $906.44 | RVU15D |
| 2015-07-01 | $906.76 | $906.44 | RVU15C |
| 2015-04-01 | $902.25 | $901.93 | RVU15B |
| 2015-01-01 | $902.25 | $901.93 | RVU15A |
| 2014-10-01 | $897.81 | $897.81 | RVU14D |
| 2014-07-01 | $897.81 | $897.81 | RVU14C |
| 2014-04-01 | $897.81 | $897.81 | RVU14B |
| 2014-01-01 | $897.81 | $897.81 | RVU14A |
| 2013-10-01 | $866.91 | $866.91 | RVU13D |
| 2013-07-01 | $866.91 | $866.91 | RVU13C |
| 2013-04-01 | $866.91 | $866.91 | RVU13B |
| 2013-01-01 | $866.91 | $866.91 | RVU13AR |
Where the Iowa rate applies
Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.
- Ackley
- Ackworth
- Adair
- Adel
- Afton
- Agency
- Ainsworth
- Akron
90951 billing questions
How many visits support 90951?
The patient must have at least four face-to-face visits with a physician or other qualified health care professional during the month. The record should support the visits and the ESRD-related management.
Is 90951 billed once for each visit?
No. It represents monthly ESRD-related management, selected by the monthly visit count rather than billed as a separate unit for each visit.
When should 90952 or 90953 be used instead?
For a patient younger than 2 years, 90952 is the sibling for two or three face-to-face visits in the month, and 90953 is for one visit.
Does 90951 describe home dialysis management?
For a patient receiving home dialysis, compare the age-based home-dialysis monthly codes 90963–90966 rather than choosing this code solely by visit count.
What documentation supports the monthly service?
Document the patient's age category, dates of face-to-face visits, and the ESRD-related assessment and management performed, such as review of dialysis needs, fluid status, access, or relevant laboratory findings.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
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