CRNA payment and Reimbursement

CRNA Reimbursement

Payment can be made for medical or surgical services furnished by non-medically directed qualified anesthetists if they are allowed to furnish these services under state law. These services may include the insertion of the Swan-Ganz catheters, central venous pressure lines, intra-arterial lines, pain management, emergency intubation and the pre-anesthetic examination and evaluation of a patient who does not undergo surgery. Payment is determined under the physician fee schedule on the basis of the national physician fee schedule conversion factor, the geographic adjustment factor and the resource-based relative value units for the medical or surgical service.

Anesthesia services are assigned the same base units for physician anesthesia services using the uniform relative value guide.

Reimbursement is made on an assignment basis only.

Services furnished by qualified anesthetists are subject to the Part B deductible and coinsurance. If the Part B deductible has been satisfied, payment is based on 80 percent of the actual charge or 80 percent of the allowable amount utilizing the anesthesia calculation, whichever is less.

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