decisionhealth Newsletters, Answer Books - 2009 Issue 7 (July)
Reimbursement For CRNAs, AAs / Payment when Anesthesiologist Directs Just One CRNA, AA
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Article Overview
This article covers Medicare payment policy for anesthesia services when an anesthesiologist directs only one CRNA or AA. It provides background on how reimbursement changed over time, the role of medical direction and medical necessity, and who may need this guidance, including anesthesia billing and coding professionals.
Why This Topic Matters
Understanding how Medicare treats anesthesia services with one directed CRNA or AA is important for correct billing, payment expectations, and compliance with anesthesia reimbursement policy.
Article Sections
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Medicare policy background
Provides historical context for how Medicare recognized anesthesia services involving an anesthesiologist and an anesthetist in a single case.
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Payment methodology change
Describes the shift in Medicare payment approach beginning in 1998 and the resulting allocation of payment between anesthesia providers.
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Medically necessary dual-provider cases
Explains the general treatment of cases where two anesthesia providers are needed for the same service and how Medicare reimbursement is recognized in that setting.
What You Will Learn
- How Medicare historically treated anesthesia cases involving more than one provider
- What changed in the payment methodology beginning in 1998
- How medically necessary anesthesia team arrangements are addressed at a high level
- Which billing contexts may be affected by medical direction policy for CRNAs and AAs
Who Should Read This
- Anesthesia coders
- Medical billing staff
- Practice managers
- Compliance teams
- Anesthesiology and anesthesia practice administrators
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