Moderate sedation services
Medicare plans follow Medicare rules for coverage and billing.
Moderate (conscious) sedation is a drug-induced depression of consciousness. The patient maintains the ability to respond purposely to verbal direction or verbal direction either alone or accompanied by light tactile stimulation. Source: acep.org
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.