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Anesthesia Billing Guide
- Anesthesia Billing Codes
- Anesthesia Billing Modifiers
- Anesthesia
- Concurrent, Medical Direction and Supervision
- Daily Management and Pain Management
- Group/Member Practice Responsibilities
- Local Coverage Determinations
- Moderate (Conscious) Sedation
- Monitoring Anesthesia Services
- National Coverage Determinations
- Payment and Reimbursement
- Provider Qualifications
- Teaching Anesthesiology Services
- Resources and References
- Related Articles
Moderate (Conscious) Sedation
Moderate sedation codes 99143‒99150 were deleted and replaced with codes 99151‒99157 in 2017.
- 99151‒99157: Are not used to report administration of medications for pain control, minimal sedation, deep sedation, or monitored anesthesia care (00100‒01999).
- 99151‒99157: Include pre, intra, and post-service work associated with moderate sedation services.
- 99151 and 99152: Make a distinction between moderate sedation services furnished to patients younger than five years of age and patients five years or older.
- 99155 and 99156: Making a similar distinction between services furnished to patients younger than five years of age and patients five years or older.
- 99153: CMS final rule states that for 99153 it is a practice expense only code; therefore, if the moderate sedation takes more than 15 minutes, and the service is done in a facility setting then it would be considered a Part A service. Part B would pay for the initial 15 minutes, but anything over 15 minutes would be billable to Part A.
The same process would apply for services performed in ASC. We would allow a physician to perform in POS 24 for the first 15 minutes, but if the moderate sedation required more than 15 minutes, the additional time would be included in the facility fee for the ASC.
G0500: CMS proposed that when moderate sedation services are furnished by the same practitioner reporting the GI endoscopy procedure, practitioners would report the sedation services using HCPCS code G0500 instead of CPT code 99152. Additional time may be reported with 99153, as appropriate.
Codes that can be reported with G0500 can be found at CY 2017 Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B.
See descriptions of moderate sedation CPT/HCPCS codes below:
| Code | Description |
|---|---|
| 99151 | Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient’s level of consciousness and physiological status; initial 15 minutes of intra-service time, patient younger than 5 years of age. |
| 99152 | Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient’s level of consciousness and physiological status; initial 15 minutes of intra-service time, patient age 5 years or older. |
| 99153 | Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient’s level of consciousness and physiological status; each additional 15 minutes intra-service time. (list separately in addition to code for primary service) |
| 99155 | Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports; initial 15 minutes of intra-service time, patient younger than 5 years of age. |
| 99156 | Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports; initial 15 minutes of intra-service time, patient age 5 years or older. |
| 99157 | Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports; each additional 15 minutes intra-service time. (list separately in addition to code for primary service) |
| G0500 | Moderate sedation services provided by the same physician or other qualified health. |
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Revised 10/25/2024