Applies to
All plans
Medicare plans follow Medicare rules for coverage and billing.
Medical policy
Moderate sedation billing
Payable: When billed by the same physician or qualified health professional who performs the service requiring sedation
Not payable: By a separate anesthesiologist
Sedation with surgery
When a provider bills the moderate sedation codes in addition to surgical code(s), notes may be requested. Refer to the CPT manual for moderate sedation codes.