CPT code 90952 denotes monthly physician management of end stage renal disease (ESRD) for patients under age 2, requiring two to three face-to-face visits per month. This code captures comprehensive, ongoing care coordination and clinical management for a high-acuity pediatric population. Nationally, accurate use of this code matters for appropriate payment, care continuity, and resource planning for pediatric dialysis and ESRD programs.

Key payers referenced include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines payer coverage patterns, billing benchmarks, common modifiers in payer policies, and clinical context for utilization of 90952.

Readers will learn where 90952 fits within pediatric ESRD service lines, the typical sites of service where this work occurs, and what billing teams need to document to support monthly comprehensive management that includes multiple face-to-face encounters. The report also summarizes common policy considerations and billing practice implications at a national level. Data not available in the input is noted where applicable.