Skip to main content

Military Health System

Utility Navigation Links

TRICARE Policy Manual 6010.63-M, April 2021
Anesthesia
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:  
1.0  CPT CODES
99151 - 99153, 99155 - 99157
2.0  HCPCS Code
G0500
3.0  DESCRIPTION
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.
4.0  POLICY
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) 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 codes 99155 - 99157, if the site is in a facility setting.
- END -
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on Twitter Follow us on YouTube Sign up on GovDelivery