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TRICARE Policy Manual 6010.60-M, April 1, 2015
Chapter 3
Section 1.2
Moderate (Conscious) Sedation
Issue Date:  
Copyright:  CPT only © 2006 American Medical Association (or such other date of publication of CPT). All Rights Reserved.
Revision:  C-29, August 9, 2018
99151 - 99153, 99155 - 99157
2.0  HCPCS Procedure Code
Moderate (conscious) sedation is a drug induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation.
4.1  Conscious sedation is bundled into many procedures. Conscious sedation is not covered separately when provided by the same physician as it is considered an integral part of the primary procedure.
4.2  If a physician performs a procedure that does not bundle conscious sedation and the same physician also performs moderate sedation, it is appropriate to separately bill Current Procedural Terminology (CPT) procedure codes 99151 - 99153.
4.3  If a second physician performs conscious sedation (other than the professional performing the diagnostic or therapeutic service) it is appropriate to separately bill CPT procedure codes 99155 - 99157, if the site is in a facility setting.
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