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90953 Esrd serv 1 visit p mo <2yrs

What 90953 is

CMS fee schedule short descriptor: Esrd serv 1 visit p mo <2yrs.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 90953 (CY2026)

This code has no Physician Fee Schedule rate: Carrier-priced - the Medicare contractor sets the price. It may be paid under a different fee schedule (clinical laboratory, DMEPOS, anesthesia) or not paid at all - check the relevant CMS schedule.

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Medically Unlikely Edit (MUE)

Medicare caps 90953 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 90953? These codes are bundled into it

90953 is a Column 1 code in 158 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 codeShort descriptionModifier indicator
0407U1 - modifier may bypassCheck pair
0591THlth&wb coaching indiv 1st1 - modifier may bypassCheck pair
0592THlth&wb coaching indiv f-up1 - modifier may bypassCheck pair
0593THlth&wb coaching group1 - modifier may bypassCheck pair
36591Draw blood off venous device0 - no modifier bypassCheck pair
36592Collect blood from picc0 - no modifier bypassCheck pair
96160Pt-focused hlth risk assmt1 - modifier may bypassCheck pair
96161Caregiver health risk assmt1 - modifier may bypassCheck pair
96523Irrig drug delivery device0 - no modifier bypassCheck pair
97802Medical nutrition indiv in0 - no modifier bypassCheck pair
97803Med nutrition indiv subseq0 - no modifier bypassCheck pair
97804Medical nutrition group0 - no modifier bypassCheck pair
98000Synch audio-video new sf 151 - modifier may bypassCheck pair
98001Synch audio-video new low 301 - modifier may bypassCheck pair
98002Synch audio-video new mod 451 - modifier may bypassCheck pair
98003Synch audio-video new hi 601 - modifier may bypassCheck pair
98004Synch audio-video est sf 101 - modifier may bypassCheck pair
98005Synch audio-video est low 201 - modifier may bypassCheck pair
98006Synch audio-video est mod 301 - modifier may bypassCheck pair
98007Synch audio-video est hi 401 - modifier may bypassCheck pair
98008Synch audio-only new sf 151 - modifier may bypassCheck pair
98009Synch audio-only new low 301 - modifier may bypassCheck pair
98010Synch audio-only new mod 451 - modifier may bypassCheck pair
98011Synch audio-only new high 601 - modifier may bypassCheck pair
98012Synch audio-only est sf 101 - modifier may bypassCheck pair
98013Synch audio-only est low 201 - modifier may bypassCheck pair
98014Synch audio-only est mod 301 - modifier may bypassCheck pair
98015Synch audio-only est high 401 - modifier may bypassCheck pair
98016Brief comunicaj tech-bsd svc1 - modifier may bypassCheck pair
99202Office o/p new sf 15 min1 - modifier may bypassCheck pair

Showing 30 of 158 column 2 codes. Use the pair checker for any specific combination.

90953 is bundled into these codes

90953 appears as a Column 2 code in 24 active edits. Reported with one of these Column 1 codes on the same date of service, 90953 is the code that denies.

Column 1 codeShort descriptionModifier indicator
90951Esrd serv 4 visits p mo <2yr0Check pair
90952Esrd serv 2-3 vsts p mo <2yr0Check pair
90954Esrd serv 4 vsts p mo 2-110Check pair
90955Esrd srv 2-3 vsts p mo 2-110Check pair
90956Esrd srv 1 visit p mo 2-110Check pair
90957Esrd srv 4 vsts p mo 12-190Check pair
90958Esrd srv 2-3 vsts p mo 12-190Check pair
90959Esrd serv 1 vst p mo 12-190Check pair
90960Esrd srv 4 visits p mo 20+0Check pair
90961Esrd srv 2-3 vsts p mo 20+0Check pair
90962Esrd serv 1 visit p mo 20+0Check pair
90963Esrd home pt serv p mo <2yrs0Check pair
90964Esrd home pt serv p mo 2-110Check pair
90965Esrd home pt serv p mo 12-190Check pair
90966Esrd home pt serv p mo 20+0Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.