Robotic Surgery (Commercial, Medicare and Medicaid)
Defines EmblemHealth's reimbursement stance on robotic surgical techniques and related billing for commercial, Medicare and Medicaid products, specifying what is and is not separately payable to facilities and practitioners.
Transferred policy content to individual company-branded template. No changes to policy title or policy number.
Reformatted and reorganized policy, transferred content to new template with new Reimbursement Policy Number (EmblemHealth ConnectiCare, 4/2022).
Robotic Surgery Coverage Criteria
Robotic surgery coverage rules
Coverage and billing criteria for procedures performed with robotic assistance:
ALL of the following
- HCPCS S2900 is not separately reimbursable; when reported, reimbursement is considered included in the primary surgical procedure.
- Facilities (hospitals, surgery centers, ASCs) will not receive additional professional or technical reimbursement for use of robotic surgical devices; these costs are considered capital equipment expenses and are included in Operating Room charges (revenue code 0360) or the facility fee for ASC claims.
- Supplies related to the use of the robotic system are disallowed as separate billable items.
- Modifier 22 may not be used solely to report robotic assistance; it is allowable only when documentation supports substantial additional work unrelated to the use of the robotic system.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.