Code changes for Moderate Sedation

1. Moderate Sedation Coding Update
For 2017, the AMA revised the codes and coding rules for moderate (conscious) sedation. In prior
years, moderate sedation was bundled to (e.g., not separately reported or paid) with nearly 450 CPT®
codes. Now, moderate sedation always is reported and paid separately, when medically necessary
and properly documented. The CPT® codebook replaced the previous moderate sedation codes with
six new codes
When a different provider performs the primary procedure and the moderate sedation, the
appropriate codes are:
99155 Moderate sedation services provided by a physician or other qualified healthcare professional
other than the physician or other qualified healthcare professional performing the diagnostic or
therapeutic service that the sedation supports; initial 15 minutes of intraservice time, patient younger
than 5 years of age
99156 … initial 15 minutes of intraservice time, patient age 5 years or older
99157 … each additional 15 minutes intraservice time (List separately in addition to code for primary
service)

2. When the same provider performs the primary procedure and the moderate sedation, the appropriate
codes are:
99151 Moderate sedation services provided by the same physician or other qualified healthcare
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 intraservice time, patient younger
than 5 years of age
99152 …initial 15 minutes of intraservice time, patient age 5 years or older
99153 … each additional 15 minutes intraservice time (list separately in addition to code for primary
service)
Although the provider performing the primary procedure will report the moderate sedation, there must be
a trained observer to assist.