00731 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 00731

Payer coverage policies that name 00731

00731 appears in 6 coverage policies from Anthem, Blue Cross & Blue Shield of Mississippi, Blue Cross & Blue Shield of Rhode Island, Blue Cross Blue Shield of Massachusetts, Centene.

PayerPolicyRole in policyReviewedDocument
AnthemAnesthesia Services and Moderate (“Conscious”) Sedation (CG-MED-21)covered if criteria are met (range 00700-00797)Nov 6, 2025payer document
AnthemMonitored Anesthesia Care for Gastrointestinal Endoscopic Procedures (CG-MED-34)covered if criteria are metFeb 19, 2026payer document
Blue Cross & Blue Shield of MississippiMonitored Anesthesia Care During Gastrointestinal Endoscopy (L.7.02.403)covered if criteria are metpayer document
Blue Cross & Blue Shield of Rhode IslandMonitored Anesthesia Care for Gastrointestinal Endoscopic Procedurescovered if criteria are metJan 21, 2026payer document
Blue Cross Blue Shield of MassachusettsMonitored Anesthesia Care (MAC) (154)listed, no stancepayer document
CenteneAnesthesiology Services for Gastrointestinal Endoscopy (CP.MP.161)covered if criteria are metMay 1, 2019payer 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: $82.32 (physician, non-facility), effective Jan 1, 2026
  • IN: $0.00 (professional, facility), effective Jan 1, 2018
  • KY: $45.00 (asc), effective Jan 1, 2026
  • MA: $5.00 (anesthesia), effective Aug 1, 2021
  • MS: $5.00 (anesthesia), effective Jan 1, 2018
  • NY: $5.00 (physician_anesthesia), effective Apr 1, 2026
  • OK: $37.75 (physician, non-facility), effective Jul 1, 2026
  • TX: $5.00 (certified_registered_nurse_anesthetist_crna_anesthesiologist, Certified Registered Nurse Anesthetist (Crna) / Anesthesiologist Assistant (Aa), facility), effective Jan 1, 2018
  • VA: $5.00 (medical), effective Jan 1, 2018
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $5.00 (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.