Hospital and Professional Reimbursement

The sustainability of a sedation service depends on its ability to generate revenue, both for the providers and for the facility/institution. A complete understanding of the process of coding and billing to achieve maximum reimbursement is necessary for planning a new sedation service, as well as maintaining and expanding an existing one. This section discusses CPT coding and billing for deep sedation, moderate sedation, provider consulting, and facility fees. Coding and billing for deep sedation involves using CPT codes for anesthesia services. Coding and billing for moderate sedation involves the use of the moderate sedation CPT codes that were updated for 2017. Coding and billing for hospital services associated with providing deep sedation involves the use of facility revenue codes.