G0453 Cont intraop neuro monitorContinuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition to primary procedure)
Status A: active, paid separately under the PFS if covered. National amounts: non-facility $27.39, facility $27.39 (total RVUs 0.82 / 0.82 × $33.4009 conversion factor; non-facility NA: rarely or never done in that setting). Work RVU 0.60, practice expense RVU 0.17 non-facility and 0.17 facility, malpractice RVU 0.05. Global period XXX. Qualifying APM participants are paid at a $33.5675 conversion factor.
2 of 2 payer prior-auth lists that name G0453 require prior authorization or set conditions: Blue Cross Blue Shield of Arizona (AZ Blue).
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Blue Cross Blue Shield of Arizona (AZ Blue) | Standard PA code list (most commercial plans) | AZ | prior auth required | Sep 1, 2026 | AZ Blue Standard Prior Authorization Requirements Code List (09/01/2026) | |
| Blue Cross Blue Shield of Arizona (AZ Blue) | State of Arizona employee group (SYD, S3Z) | AZ | prior auth required | Sep 1, 2026 | State of Arizona Group Prior Authorization Requirements Code List (09/01/2026) |
G0453 appears in 14 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Blue Cross & Blue Shield of Rhode Island, Blue Cross Blue Shield of Massachusetts, Blue Shield of California, BlueCross BlueShield of South Carolina, Cigna, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Epilepsy Surgery (0394) | not covered | Jun 23, 2026 | payer document |
| Aetna | Grid Monitoring and Intraoperative Electroencephalography (0289) | covered if criteria are met | Apr 17, 2026 | payer document |
| Aetna | Intraoperative Neurophysiological Monitoring (0697) | covered if criteria are met | Jun 19, 2026 | payer document |
| Aetna | Lunsotogene Parvec-cwha (Otarmeni) (1103) | listed, no stance | Aug 12, 2026 | payer document |
| Aetna | Spinal Cord Stimulation (0194) | not covered | Sep 10, 2026 | payer document |
| Anthem | Intraoperative Neurophysiological Monitoring (CG-SURG-104) | covered if criteria are met | Feb 19, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Intraoperative Neurophysiologic Monitoring | unproven / investigational | payer document | |
| Blue Cross & Blue Shield of Rhode Island | Remote Intraoperative Neurophysiologic (IONP) Monitoring | covered if criteria are met | May 20, 2026 | payer document |
| Blue Cross Blue Shield of Massachusetts | Intraoperative Neurophysiologic Monitoring (211) | unproven / investigational | payer document | |
| Blue Shield of California | Intraoperative Neurophysiologic Monitoring (7.01.58) | listed, no stance | payer document | |
| BlueCross BlueShield of South Carolina | Intraoperative Neurophysiologic Monitoring (CAM 70158) 95955 | Electroencephalogram (EEG) during non-intracranial surgery (e.g., carotid surgery) | listed, no stance | Jan 1, 2026 | payer document |
| Cigna | Intraoperative Monitoring (0509) | covered if criteria are met | Sep 15, 2025 | payer document |
| Cigna | Intraoperative Monitoring (0509) | not covered | Sep 15, 2025 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Intraoperative Neurophysiologic Monitoring (IONM) (MED205.011) CPT Codes 95829, 95865, 95867, 95868, 95907, 95908, 95909, 95910, 95911, | listed, no stance | Sep 15, 2026 | payer document |
| Premera Blue Cross | Intraoperative Neurophysiologic Monitoring (7.01.562) | listed, no stance | Jun 9, 2026 | payer document |
Prior authorization required or conditional in IN.
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.