Sometimes referred to as ​“IV” or ​“procedural” sedation, conscious sedation involves administering pharmacological agents to produce a medically controlled state of depressed consciousness that still allows a patient to respond to physical stimulation and verbal commands and maintain an unassisted airway. 

Conscious sedation alleviates anxiety and pain associated with potentially unpleasant procedures. The practitioner can achieve a range of levels of sedation depending on the drug used. 

The Manitoba Physicians Manual includes the following two tariffs that may apply to services for conscious sedation:

8957* Therapeutic Injection, Intravenous (Injection) $11.80

2651 Procedural sedation by physician $51.00

Tariff 2651 is listed under the Community Based Clinical Services Heading in the General Schedule of the Physicians Manual. Therefore, tariff 2651 may only be claimed when conscious sedation is personally rendered by the claiming physician in a facility that is privately owned. This can be claimed for any service where conscious sedation is provided, including endoscopy or other diagnostic or therapeutic services.

When tariff 2651 does not apply to the service provided, likely due the facility being operated by a Health Authority the claiming physician should consider tariff 8957*. Tariff 8957* includes the following notes:

• When a physician performs a venipuncture and injects medication, the service may be claimed under tariff 8957.

• Injecting medication into I.V. tubing by a physician or staff person is not claimable.

Billing Advice

1. Only where the physician personally renders conscious sedation should a claim for 2651 or 8957* be considered.
2. If administered in a privately owned facility claim tariff 2651.
3. If administered in a publicly operated facility, and the claiming physician personally rendered the venipuncture and injected medication, then claim 8957*.
4. If administered in a publicly operated facility and the medication is injected into an established IV, then conscious sedation is not claimable.
5. Tariff 8957 is not payable in addition to tariff 2651.

Where the physician performing a procedure requires an anesthetist to provide the conscious sedation service the anesthetist may claim for anesthetic services rendered in accordance with the anesthesia schedule of the Physicians Manual.

In an emergent situation, if a physician, who is not eligible to claim as an anesthetist, is requested by the physician performing the procedure to provide conscious sedation, he or she may claim on a By Report basis. In this circumstance, Doctors Manitoba recommends that a fee roughly equivalent to the anesthetic fee be submitted. This fee is calculated as 20 times the current anesthetic unit values for every 15 minutes or portion thereof.