00812 CPT® code: payer coverage and prior authorization1 of 1 payer prior-auth lists that name 00812 require prior authorization or set conditions: Blue Shield of California.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Blue Shield of California | Blue Shield commercial | CA | prior auth under conditions | CalPERS ASO only | Sep 1, 2026 | Prior Authorization List for Blue Shield |
00812 appears in 8 coverage policies from Anthem, Blue Cross & Blue Shield of Mississippi, Blue Cross & Blue Shield of Rhode Island, Blue Cross Blue Shield of Massachusetts, Centene, Premera Blue Cross, UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Anthem | Anesthesia Services and Moderate (“Conscious”) Sedation (CG-MED-21) | covered if criteria are met (range 00800-00882) | Nov 6, 2025 | payer document |
| Anthem | Monitored Anesthesia Care for Gastrointestinal Endoscopic Procedures (CG-MED-34) | covered if criteria are met | Feb 19, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Monitored Anesthesia Care During Gastrointestinal Endoscopy (L.7.02.403) | covered if criteria are met | payer document | |
| Blue Cross & Blue Shield of Rhode Island | Monitored Anesthesia Care for Gastrointestinal Endoscopic Procedures | covered if criteria are met | Jan 21, 2026 | payer document |
| Blue Cross Blue Shield of Massachusetts | Monitored Anesthesia Care (MAC) (154) | listed, no stance | payer document | |
| Centene | Anesthesiology Services for Gastrointestinal Endoscopy (CP.MP.161) | covered if criteria are met | May 1, 2019 | payer document |
| Premera Blue Cross | Preventive Care | covered if criteria are met | Sep 21, 2026 | payer document |
| UnitedHealthcare | Preventive Care Services (MP.016.59) Procedure Code(s): | Age Limits: 45 to 75 years (ends on | listed, no stance | Jul 1, 2026 | payer document |
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.