90952
No office rateEsrd serv 2-3 vsts p mo <2yr
Both codes cover monthly ESRD-related management for patients younger than 2 years. Use 90952 for two or three face-to-face visits; 90951 requires at least four.
On this page
CMS RVU26D · Effective 2026-10-01
90951 ESRD monthly care Medicare reimbursement rates in Texas
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. Compare 90951 office and facility rates across CMS payment localities in Texas.
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 90951 in Texas?
Texas has 8 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 8 payment areas shown below, using the same CMS release.
Office / nonfacility
$1150.02–$1206.10
8 of 8 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.
Where 90951 pays more and less in Texas
8 payment localities
$1150.02 to $1206.10
Nephrology
About 90951: ESRD monthly management, four or more visits
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.
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.
Where the value comes from
- Work RVU23.92 · 67%
- Practice expense (office) RVU10.06 · 28%
- Malpractice RVU1.46 · 4%
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.
90951 compared with similar codes
Office rates for Texas, from the same CMS release.
90953
No office rateEsrd serv 1 visit p mo <2yrs
90953 is the one-visit monthly level for a patient younger than 2 years. 90951 requires at least four face-to-face visits during the month.
$606.72–$637.53
90963 is the monthly code family for home dialysis patients younger than 2 years. 90951 is selected by the four-or-more visit level in the other monthly ESRD service family.
$17.78–$18.67
90967 reports age-specific ESRD services by day for a patient younger than 2 years; 90951 represents the monthly service at the four-or-more visit level.
Compare 90951 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.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Office $1199.26 | Facility $1199.26 |
| Beaumont | Office $1150.02 | Facility $1150.02 |
| Brazoria | Office $1176.37 | Facility $1176.37 |
| Dallas | Office $1182.65 | Facility $1182.65 |
| Fort Worth | Office $1179.92 | Facility $1179.92 |
| Galveston | Office $1179.38 | Facility $1179.38 |
| Houston | Office $1206.10 | Facility $1206.10 |
| Rest Of Texas | Office $1161.86 | Facility $1161.86 |
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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 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.
11,56190940,,Hemodialysis access study,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
11,56290945,,Dialysis one evaluation,A,,1.52,0.70,NA,0.70,,0.09,2.31,2.31,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,56390947,,Dialysis repeated eval,A,,2.46,0.55,NA,0.55,,0.17,3.18,3.18,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,56490951,,Esrd serv 4 visits p mo <2yr,A,,23.92,10.06,,10.06,,1.46,35.44,35.44,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,56590952,,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