Medicare uses anesthesia codes and base values adopted from the list values established by the American Society of Anesthesiologists (ASA).
Anesthesia administration includes the following services:
** Preoperative and postoperative visits
** Anesthesia care during the procedure
** Administration of fluids and blood
** Usual monitoring (e.g., ECG, temperature, blood pressure, oximetry, capnography, mass spectrometry) as defined by ASA (American Society of Anesthesiologists) and/or CPT guidelines.
General Anesthesia is personally performed by an anesthesiologist or CRNA/AA (medically directed by an anesthesiologist, or medically supervised by an anesthesiologist).
Outlined below is general information related to the reimbursement formulas used by Medicare:
Personally Performed and Medically Directed Formula
(ASA Base Units) + (Total Time / 15 rounded up to a whole unit x Current Conversion Factor
Allow three (3) base units, and one (1) additional base unit when it is demonstrated that the physician was present at the induction x Current Conversion Factor
Personally Performed – 100% of the allowed amount
Medically Directed – 50% of the allowed amount