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Reimbursement Policy Reminder: Moderate Sedation July 01, 2025 Claims & Coding

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.

Disclosures:

Blue Cross and Blue Shield of North Carolina Senior Health, DBA Blue Cross and Blue Shield of North Carolina, is an HMO-POS D-SNP plan with a Medicare contract and a NC State Medicaid Agency Contract (SMAC). Enrollment in Blue Cross and Blue Shield of North Carolina Senior Health depends upon contract renewal.

NCBCBS-CR-082525-25-CPN81329 June 2025

Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. Learn more about our non-discrimination policy and no-cost services available to you.

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