$1,020.25–$1,067.00
Both cover monthly ESRD-related care for patients aged 2 through 11. Choose 90954 for four or more face-to-face visits, not two or three.
On this page
CMS RVU26D · Effective 2026-10-01
90955 Monthly ESRD care Medicare reimbursement rates in Oregon
Monthly ESRD-related management for a patient aged 2–11 when the physician or qualified health care professional provides two or three face-to-face visits. Compare 90955 office and facility rates across CMS payment localities in Oregon.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 90955 in Oregon?
Oregon has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$531.38–$557.60
2 of 2 localities have a supported rate.
Facility setting
$531.38–$557.60
2 of 2 localities have a supported rate.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Nephrology
About 90955: Pediatric monthly ESRD care, 2-3 visits
Monthly ESRD-related management for a patient aged 2–11 when the physician or qualified health care professional provides two or three face-to-face visits.
CPT 90955 represents monthly end-stage renal disease (ESRD)-related care for a patient aged 2 through 11 when the physician or qualified health care professional conducts two or three face-to-face visits during the month. Pediatric nephrologists commonly report it while managing children receiving maintenance dialysis. Monthly care may involve reviewing the dialysis plan, volume and blood-pressure status, laboratory results, medications, vascular or peritoneal access concerns, and treatment complications. This is monthly management, not a code for an individual dialysis treatment.
Choose the code by the patient’s age and the number of qualifying face-to-face visits during the month. The record should support the visit dates and the renal management provided; count these visits, not dialysis sessions. Report the monthly service once for the applicable month, rather than assigning 90955 to each visit. CMS assigns work, practice-expense, and malpractice relative value units to the service; payment rates are shown separately in the fee schedule data.
Where the value comes from
- Work RVU10.32 · 64%
- Practice expense (office) RVU5.16 · 32%
- Malpractice RVU0.64 · 4%
81
Medicare services in 2024 · #5044 by national volume
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.
90955 compared with similar codes
Office rates for Oregon, from the same CMS release.
$362.15–$381.36
This is the one-visit monthly level for patients aged 2 through 11; 90955 is for two or three visits.
$511.99–$537.50
This covers two or three monthly visits for patients aged 12 through 19. Use 90955 for the same visit range when the patient is aged 2 through 11.
No office rate
90945 describes evaluation associated with an individual dialysis service other than hemodialysis. 90955 represents monthly ESRD-related care selected by age and face-to-face visit count.
Compare 90955 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
2 of 2 payment localities
Portland →
Office / nonfacility
$557.60
Facility
$557.60
Rest Of Oregon →
Office / nonfacility
$531.38
Facility
$531.38
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90955 billing questions
How many visits support 90955?
The patient must be 2 through 11 years old and have two or three qualifying face-to-face visits during the month. The number of dialysis sessions does not determine the visit level.
Should 90955 be reported for each monthly visit?
No. It represents the monthly ESRD-related service, so report it once for the month rather than once per face-to-face visit.
When should 90954 be used instead?
For a patient aged 2 through 11, use 90954 when the monthly visit count meets the four-or-more-visit level. Use 90955 for two or three visits.
What documentation supports 90955?
Document the patient's age, the dates of the two or three face-to-face visits, and the ESRD-related assessment and management furnished at those visits.
Is 90955 for an individual dialysis-session evaluation?
No. It represents monthly ESRD-related care. Codes such as 90935 or 90945 describe evaluation associated with an individual dialysis service, rather than this monthly visit-count service.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
11,56590952,,Esrd serv 2-3 vsts p mo <2yr,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,56690953,,Esrd serv 1 visit p mo <2yrs,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,56790954,,Esrd serv 4 vsts p mo 2-11,A,,20.86,8.80,,8.80,,1.31,30.97,30.97,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,56890955,,Esrd srv 2-3 vsts p mo 2-11,A,,10.32,5.16,,5.16,,0.64,16.12,16.12,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,56990956,,Esrd srv 1 visit p mo 2-11,A,,6.64,3.93,,3.93,,0.41,10.98,10.98,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,57090957,,Esrd srv 4 vsts p mo 12-19,A,,15.46,7.42,,7.42,,0.98,23.86,23.86,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,57190958,,Esrd srv 2-3 vsts p mo 12-19,A,,9.87,5.05,,5.05,,0.61,15.53,15.53,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00