3 commercial payer policies list 00104. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.
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3 policies from 2 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of 00104 |
|---|---|---|
| Anesthesia Services and Moderate (“Conscious”) Sedation | Jan 6, 2026 | Covered |
| Extraosseous Subtalar Joint Implantation and Subtalar Arthroereisis | Oct 1, 2026 | Not covered |
| Policy | Effective | Status of 00104 |
|---|---|---|
| Electroconvulsive Therapy | Sep 21, 2023 | Covered |