CurrentSelectHealthPolicy # 66

Robotic-assisted Surgery Reimbursement

Governs SelectHealth reimbursement stance for robotic-assisted surgical procedures across Commercial, Medicare (Select Health Advantage), and Medicaid (Select Health Community Care) products; specifies that robotic assistance is integral to the primary surgical procedure and not separately reimbursed.

Policy Summary

PayerSelectHealth

PolicyRobotic-assisted Surgery Reimbursement

Policy CodePolicy Policy # 66

Change TypeNo material changes

Effective DateJun 1, 2016

Next Review Date

Key ActionDo not bill HCPCS S2900 separately; robotic assistance is considered integral to the primary surgical procedure and is not separately reimbursed.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

Not reimbursedS2900 status

IntegralReimbursement stance

Follows MedicareMedicare dependency

Follows Utah MedicaidMedicaid dependency

55866CPT example

Coverage Rules

Policy Summary

PayerSelectHealth

PolicyRobotic-assisted Surgery Reimbursement

Policy CodePolicy Policy # 66

Change TypeNo material changes

Effective DateJun 1, 2016

Next Review Date

Key ActionDo not bill HCPCS S2900 separately; robotic assistance is considered integral to the primary surgical procedure and is not separately reimbursed.

SourceLink

On This Page

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.

Coverage rules by product

Robotic assistance is considered integral to the primary surgical procedure. Coverage depends on whether the primary procedure is covered for the member's product.

Commercial & CHIP: Procedures using robotic assistance are covered when the primary surgical procedure is covered by the benefit plan; robotic assistance is considered an integral part of the surgical service and is not separately reimbursed.

Commercial & CHIP: Select Health does NOT provide additional reimbursement for the use of robotic devices, including HCPCS code S2900.

Commercial & CHIP: Modifier 22 may not be used to report and bill for the use of robotic assistance alone; it may only be used for unrelated unusual complications or complexities occurring during the procedure.

Select Health Advantage (Medicare): Procedures using robotic assistance are covered only if the primary procedure is covered by standard Medicare; HCPCS S2900 is not covered by Medicare and is not separately reimbursable.

Select Health Community Care (Medicaid): Procedures using robotic assistance are covered only if the primary procedure is covered by Utah State Medicaid; HCPCS S2900 is not covered by Utah Medicaid and is not separately reimbursable.

Billing and Documentation Guidance for Providers

Billing Rule

Commercial plans: Robotic assistance is integral — S2900 not separately reimbursable

Select Health considers robotic assistance integral to the primary surgical procedure and will not reimburse the use of robotic devices separately under Commercial plans; Procedure code S2900 is not reimbursed separately.

Do not submit S2900 as a separately payable service for Commercial or CHIP members.

Billing Rule

Select Health Advantage (Medicare): S2900 not covered

Select Health Advantage follows Medicare’s coverage and does not cover HCPCS code S2900; S2900 is not separately reimbursable with any procedure for Medicare members.

Do not bill S2900 separately for Select Health Advantage (Medicare) members.

Billing Rule

Select Health Community Care (Medicaid): S2900 not covered

Select Health Community Care follows Utah Medicaid and does not cover HCPCS code S2900; S2900 is not separately reimbursable with any procedure for Medicaid members.

Do not bill S2900 separately for Select Health Community Care (Medicaid) members.

Billing Rule

Modifier 22: Not allowed for robotic assistance alone

Modifier 22 must not be used solely to report or bill for the use of robotic assistance; it may be appropriate only to report unrelated unusual complications or complexities that occurred during the surgical procedure.

If Modifier 22 is used, document the unrelated unusual complication or complexity — not the use of the robotic system — to support additional payment.

Definitions and System Components

inv-08: Definition — Robotic surgery

DefinitionRobotic surgery: application of computer-assisted robotic technologies to enhance the surgeon's ability to carry out surgical procedures (commonly endoscopic/laparoscopic), e.g., systems like the da Vinci Surgical System.

PurposeMethod of automating laparoscopic procedures to reduce trauma and improve outcomes.

Common useMost commonly used for endoscopic/laparoscopic procedures across a range of surgical indications.

inv-09: Robotic system components

Surgeon consoleWhere the surgeon sits while viewing a 3-D image of the surgical field and controls 2 or 3 instrument arms and an endoscope arm.

Robotic arm cartContains the robotic arms that translate the surgeon's hand, wrist, and finger movements into precise, scaled movements in the operative field.

Master handlesProvide direction to the robotic arms and control aspects of the video display system and motion scaling.

Articulating instruments (Endowrist)Robotic surgical instruments with an elbow joint and wrist enabling seven degrees of freedom and two degrees of axial rotation to replicate hand movements and reduce tremor.

OpenPayer

Robotic-assisted Surgery Reimbursement

Coverage Rules

Relevant Procedure and HCPCS Codes

Billing and Documentation Guidance for Providers

Definitions and System Components