Dialysis CPT Codes and Modifiers for 2025
Mar 17, 2025
Dialysis billing is highly specialized and closely regulated—especially when managing ESRD patients and submitting monthly capitation codes (MCP). Using the correct dialysis CPT codes and modifiers in 2025 helps ensure compliance with CMS rules and secures proper reimbursement for both routine and complex services.
Monthly ESRD-Related Services (MCP)
| CPT Code | Description |
|---|---|
| 90951 | ESRD-related services, <2 years, 4+ visits |
| 90952 | <2 years, 2–3 visits |
| 90953 | <2 years, 1 visit |
| 90954 | Age 2–11, 4+ visits |
| 90955 | Age 2–11, 2–3 visits |
| 90956 | Age 2–11, 1 visit |
| 90957 | Age 12–19, 4+ visits |
| 90958 | Age 12–19, 2–3 visits |
| 90959 | Age 12–19, 1 visit |
| 90960 | Age 20+, 4+ visits |
| 90961 | Age 20+, 2–3 visits |
| 90962 | Age 20+, 1 visit |
| 90963 | Home dialysis, <2 years |
| 90964 | Home dialysis, age 2–11 |
| 90965 | Home dialysis, age 12–19 |
| 90966 | Home dialysis, age 20+ |
Individual Dialysis Sessions
| CPT Code | Description |
|---|---|
| 90935 | Hemodialysis, single evaluation |
| 90937 | Hemodialysis, repeated evaluations |
| 90945 | Peritoneal dialysis, one-time |
| 90947 | Peritoneal dialysis, repeated evaluations |
Dialysis Training & Supervision
| CPT Code | Description |
|---|---|
| 90989 | Dialysis training, initial |
| 90993 | Dialysis training, additional |
Dialysis Modifiers
| Modifier | Description |
|---|---|
| -25 | Separate E/M on same day as dialysis |
| -26 | Professional component only |
| -GC | Resident under supervision |
| -G1 | ESRD patient with 4+ sessions/month |
| -G2 | ESRD patient with 2–3 sessions/month |
| -G3 | ESRD patient with 1 session/month |
| -G4 | ESRD patient on home dialysis |
ICD-10 Codes Commonly Paired With Dialysis
| ICD-10 Code | Description |
|---|---|
| N18.6 | End-stage renal disease (ESRD) |
| Z99.2 | Dependence on renal dialysis |
| T86.10 | Kidney transplant complication |
| Z94.0 | Kidney transplant status |
| I12.9 | Hypertensive CKD without heart failure |
| N17.9 | Acute kidney failure, unspecified |
Dialysis Billing Tips for 2025
Final Thoughts
Dialysis coding is a core component of nephrology billing—and accuracy is essential. Use this 2025 dialysis CPT code and modifier guide to protect your practice from underpayments and denials while staying compliant with Medicare and commercial payers.
For informational purposes only.
Contact us
“My husband and I have a small practice but we were looking for a medical billing company to consult us. We originally started with a local company with some satisfaction. However, our biggest problem was that they wanted us to change our existing EMR to software that they worked with. Quest National Services worked with our existing software so that we didn’t have to make expensive changes to our infrastructure. That saved us a lot of time and headache. I would definitely say that was one of the main reasons for why we switched and why we continue to work with Quest. As a small practice, they helped us without draining our resources.”
Adriana C.
