00537 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 00537

Payer coverage policies that name 00537

00537 appears in 1 coverage policy from Anthem.

PayerPolicyRole in policyReviewedDocument
AnthemAnesthesia Services and Moderate (“Conscious”) Sedation (CG-MED-21)covered if criteria are met (range 00500-00580)Nov 6, 2025payer document

Medicaid fee-for-service

  • AZ: $32.12 (anesthesia), effective Oct 1, 2026
  • CO: $16.98 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $164.63 (physician, non-facility), effective Jan 1, 2026
  • IN: $0.00 (professional, facility), effective Jan 1, 2024
  • MA: $7.00 (anesthesia), effective Aug 1, 2021
  • MS: $10.00 (anesthesia), effective Oct 1, 2003
  • NY: $10.00 (physician_anesthesia), effective Apr 1, 2026
  • OK: $0.00 (outpatient_hospital_apc), effective Jan 1, 2026
  • TX: $10.00 (certified_registered_nurse_anesthetist_crna_anesthesiologist, Certified Registered Nurse Anesthetist (Crna) / Anesthesiologist Assistant (Aa), facility), effective Mar 1, 2023
  • VA: $7.00 (medical), effective Jan 1, 2001
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $10.00 (physician, facility), effective Jul 1, 2026
  • WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), effective Apr 1, 2026

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.