Summary & Overview
CPT 90993: Dialysis Training Session for Patient and Helper
CPT code 90993 represents dialysis training for patients, including a helper when applicable, delivered per training session. This procedure is essential in nephrology, enabling patients and their caregivers to safely manage dialysis at home. The code is widely recognized by major national payers, including Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare, reflecting its importance in coverage and reimbursement policies.
This publication provides a comprehensive overview of 90993, detailing its clinical context, typical site of service, and relevance in the management of end-stage renal disease and chronic kidney conditions. Readers will gain insights into payer coverage, common billing modifiers, and associated provider taxonomies. The article also highlights related CPT codes and ICD-10 diagnoses, offering a clear understanding of how dialysis training fits within broader nephrology care. Key policy updates and benchmarks are discussed to inform stakeholders about current trends and requirements for reporting this service. The information is designed to support healthcare professionals, administrators, and policy analysts in navigating the complexities of dialysis training billing and coverage.
CPT Code Overview
CPT code 90993 is used to report dialysis training sessions for patients, including a helper when applicable. This code is part of the nephrology service line and is typically performed in the home setting (Place of Service 12). Dialysis training is a critical component in preparing patients and their caregivers for safe and effective home dialysis, supporting patient autonomy and improving clinical outcomes.
Clinical & Coding Specifications
Clinical Context
A patient diagnosed with end stage renal disease (N18.6) or chronic kidney disease, stage 5 (N18.5) is preparing to begin home dialysis. The nephrology team, which may include a nephrology physician, nurse practitioner, or registered nurse, conducts a dialysis training session for the patient and their helper. The training covers the operation of dialysis equipment, safety protocols, and management of potential complications. This service is typically provided in the patient's home (Place of Service 12), and may be repeated as needed to ensure competency. Documentation includes the session details, participants, and progress toward independent dialysis management.
Coding Specifications
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Modifiers:
52- Reduced Services: Used when the dialysis training session is not completed in its entirety or is less comprehensive than usual.76- Repeat Procedure by Same Physician: Used when the same provider conducts multiple training sessions for the same patient.
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Provider Taxonomies:
Taxonomy Code Specialty 207RN0300XNephrology Physician 363LF0000XNurse Practitioner 163W00000XRegistered Nurse
Related Diagnoses
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N18.6- End stage renal disease- Indicates the patient has irreversible kidney failure, necessitating dialysis.
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Z49.31- Encounter for adequacy testing for hemodialysis- Used when evaluating the effectiveness of hemodialysis, relevant during training to ensure proper technique.
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Z49.01- Encounter for fitting and adjustment of extracorporeal dialysis catheter- Applies when the patient requires catheter fitting or adjustment, often part of initial training.
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Z99.2- Dependence on renal dialysis- Denotes ongoing reliance on dialysis, supporting medical necessity for training.
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N18.5- Chronic kidney disease, stage 5- Represents advanced kidney disease, typically preceding or coinciding with ESRD and dialysis initiation.
Related CPT Codes
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90999- Unlisted dialysis procedure, inpatient or outpatient- Used for dialysis procedures not otherwise specified. May be used when training does not fit standard codes.
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90989- Dialysis training, completed course- Represents completion of the entire dialysis training program. Often used after multiple sessions billed with
90993.
- Represents completion of the entire dialysis training program. Often used after multiple sessions billed with
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90970- End-stage renal disease (ESRD) related services monthly, for patients 20 years of age and older- Covers monthly management of ESRD patients. May be used alongside training codes for ongoing care.
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90960- End-stage renal disease (ESRD) related services monthly, for patients younger than 20 years of age- Similar to
90970, but for pediatric patients. Used in conjunction with training codes for younger patients.
- Similar to
Commonly Used Together:
90993is often billed for each training session, while90989is used upon completion of the training course. Monthly ESRD management codes (90970,90960) are used for ongoing care.
National Reimbursement Benchmarks
For CPT code 90993, the national mean rate for BUCA (average commercial) is $112.67, which is notably higher than typical Medicare rates, though Medicare data is not available in the input for this code. Among individual commercial payers, UnitedHealth Group has the highest mean rate at $134.18, while Aetna is the lowest at $90.13.
Rate dispersion, measured by the difference between the 75th and 25th percentiles, varies significantly across payers. Blue Cross Blue Shield shows the tightest range at $63.00, while Cigna exhibits the widest spread at $89.83, indicating greater variability in Cigna's contracted rates. UnitedHealth Group and BUCA also display substantial dispersion, suggesting a broad range of contracted rates nationally.
The table and chart below present a detailed breakdown of national benchmarks for each payer, including mean rates and percentile values.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.