Reimbursement Policy Reminder: Moderate Sedation

As a reminder, the Blue Cross and Blue Shield of North Carolina (Blue Cross NC) reimbursement policy regarding moderate sedation services was established in 2022.

Moderate (conscious) sedation services (specifically 99151, 99152, 99153) are considered incidental to Evaluation and Management services (99091-99499), Surgical services (10004-69990), and Laboratory services (0001U-89398) and is not eligible for separate reimbursement.

View the full Bundling Guidelines reimbursement policy, specifically the Moderate (Conscious) Sedation section.

This policy applies to Commercial, Inter-Plan Program (IPP) Host, and Federal Employee Program (FEP). This does not apply to Medicare Advantage or IPP Home.