CPT code 90957 covers monthly management of end stage renal disease (ESRD) for adolescents aged 12–19, requiring four or more face-to-face encounters in a month. This code captures comprehensive oversight of dialysis-related care and associated services provided by a clinician during that month. Nationally, accurate use of this code affects payment for specialized, recurring care of pediatric and adolescent ESRD patients and supports monitoring, complication management, and coordination across services.

Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical intent, common billing modifiers and coding context, and national coverage considerations. The publication outlines benchmark performance and utilization patterns where available, highlights common billing pitfalls, and summarizes relevant policy updates that affect reimbursement and documentation expectations.

This summary provides clinicians, coders, and policy professionals with the clinical context behind CPT code 90957, clarity on where the service is typically delivered, and the areas of documentation and payer policy that most commonly influence claims adjudication.