CPT code 90953 denotes monthly comprehensive face-to-face management of a child under 2 years with end stage renal disease (ESRD). This code captures the clinician’s coordination and oversight of all monthly services required for ongoing pediatric ESRD care. Given the high resource needs and complex care coordination for infants with ESRD, accurate use of this code affects national measurement of pediatric dialysis and transplant care delivery.

Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines where 90953 applies clinically, expected sites of service, and payer coverage considerations.

Readers will find national benchmarks and context for utilization and reimbursement patterns, summaries of relevant policy and coding guidance updates affecting monthly ESRD management, and clinical context describing the scope of services typically encompassed by the code. The report also highlights common billing modifiers and implementation considerations for multi-disciplinary teams caring for infants with ESRD. Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.