00797 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 00797

Payer coverage policies that name 00797

00797 appears in 2 coverage policies from Anthem, Blue Cross & Blue Shield of Mississippi.

PayerPolicyRole in policyReviewedDocument
AnthemAnesthesia Services and Moderate (“Conscious”) Sedation (CG-MED-21)covered if criteria are met (range 00700-00797)Nov 6, 2025payer document
Blue Cross & Blue Shield of MississippiMorbid Obesity (L.7.01.431)covered if criteria are metpayer document

Medicaid fee-for-service

Prior authorization required or conditional in WA.

  • AZ: $32.12 (anesthesia), effective Oct 1, 2026
  • CO: $16.98 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $164.66 (physician, non-facility), effective Jan 1, 2026
  • IN: $0.00 (professional, facility), effective Feb 1, 2015
  • MA: $11.00 (anesthesia), effective Aug 1, 2021
  • NY: $11.00 (physician_anesthesia), effective Apr 1, 2026
  • OK: $0.00 (outpatient_hospital_apc), effective Jan 1, 2026
  • TX: $11.00 (certified_registered_nurse_anesthetist_crna_anesthesiologist, Certified Registered Nurse Anesthetist (Crna) / Anesthesiologist Assistant (Aa), facility), effective Mar 1, 2019
  • VA: $7.00 (medical), effective Jan 1, 2002
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $11.00 (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.