CPT code 90958: ESRD management, age 12-19, 2-3 visits2026 Medicare rate & RVUs in Vermont

In Vermont, Medicare pays $506.96 for 90958 in the office and $506.96 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 90958 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 90958 covers

This monthly service covers a physician’s or qualified health care professional’s management of a patient ages 12 through 19 receiving treatment for end-stage renal disease. A nephrologist commonly provides the visits in a dialysis facility, hospital, or office, addressing the patient’s dialysis plan and related clinical needs, such as treatment response, laboratory findings, medications, and dialysis-related complications. The code’s visit tier is based on two or three face-to-face visits during the month, not on the number of dialysis sessions the patient receives.

Report the monthly code when the patient’s age and documented face-to-face visit count match this tier. The record should identify the services and visit dates supporting ongoing ESRD management. It is one monthly service, not a separate unit for each encounter or dialysis treatment. CMS payment is based on the physician fee schedule values for this code.

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 Vermont compares for 90958

Across 109 of 109 payment localities, the office rate for 90958 runs from $485.05 in Arkansas to $685.37 in Alaska. Vermont pays $506.96. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

90958 rates by state

Office rate range in each state. Select a state to see its payment localities.

See 90958 in every payment locality

How the 90958 rate is calculated

Each of 90958’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.

Payment rules and modifiers for 90958

90958 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.

Codes related to 90958

Related codes aren’t interchangeable: bill the code that matches the service performed.

How 90958 has changed in Vermont

Price 90958 for an earlier date of service

Where the Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

• Albany
• Alburgh
• Algiers
• Arlington
• Ascutney
• Bakersfield
• Barnet
• Barre

Browse all communities in Vermont

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

Open CMS sourceHow we calculate rates