Moderate Sedation Codes Q: Does Medicare cover CPT codes 99143-99150 new for 2006?
Based on medical necessity for each individual patient’s circumstances and as documented in the medical record, CPT codes 99148-99150 (moderate sedation services provided by a physician other than the one performing the diagnostic or therapeutic service that the sedation supports, first 30 minutes and each additional 15 minutes) may be paid. In contrast, the codes for moderate sedation provided by the physician performing the diagnostic or therapeutic procedure will not be paid by Medicare Part B. Based on CMS Publication 100-4, the Medicare Claims Processing Manual, Chapter 12, Section 50. A, separate payment for anesthesia performed by the physician who also furnished the medical or surgical service is not allowed as it is considered component to/included in the payment for the medical or surgical service.
