Moderate Sedation Reimbursement Policy

The current UnitedHealthcare Moderate Sedation reimbursement policy for Commercial plans will be retired effective Jan. 1, 2017. Per the 2017 CPT book, moderate sedation codes 99143-99145 and 99148-99150 have been deleted and replaced by new CPT codes 99151-99157. Additionally, Appendix G in the 2016 CPT book, which included a list of codes that include moderate sedation, is not included in the 2017 CPT book. The new moderate sedation CPT codes may be reported separately with the codes formerly listed in Appendix G; therefore UnitedHealthcare will no longer maintain a separate reimbursement policy for moderate sedation services. Other existing UnitedHealthcare reimbursement policies will continue to apply CMS and/or AMA sourced editing to moderate sedation services reported under the new CPT codes.

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INDUSTRY NEWS TAGS: Radiology News, UnitedHealthcare

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