Billing Guide for Anesthesiology assitand and Anesthesia time

Anesthesiology Assistants

Anesthesiology Assistants are eligible for the same level of reimbursements as a CRNA who is providing anesthesia under the direction of a physician. Unlike the CRNA who can perform alone in some states  an AA must always perform their service under the direction of a physician. (See definition of Medical Direction in General Billing Guidelines for Anesthesia)

Anesthesia Units

Anesthesia should be billed in 15-minute increments. Each 15-minute increment equals 1 unit and the
number of units should be entered into field 24G. Calculation of time starts when the practitioner is
preparing the patient for anesthesia and ends when the practitioner is no longer providing anesthesia
services. It is a continuous service.

Billing Anesthesia For Multiple Surgeries

If multiple surgical procedures are being performed in the same operative session only one anesthesia
code may be submitted. Choose the code that represents the most complicated procedure (typically the service with highest CMS Relative Value Unit). An exception exists if the anesthesia performed requires the use of an add on anesthesia code in addition to the primary procedure. Example: Primary Procedure is 01967 with add-on codes 01968, 01969.


Qualified medical professionals administer anesthesia to relieve pain while at the same time monitoring and controlling the patients’ health and vital bodily functions. Anesthesiology may be performed in the hospital, and ambulatory surgical center, and a physician’s office. Anesthesiologists and anesthesiologist- led care teams provide anesthesia. These teams include non-physician providers
such as Certified Registered Nurse Anesthetists (CRNA), Anesthesiologist Assistant (AA), interns,
residents, or a combination of both who may be either medically directed or medically supervised by
an Anesthesiologist.

Anesthesia service includes:
1. Pre-anesthetic evaluation and management
2. Medical management of the patient during the procedure
3. Post-anesthetic evaluation and treatment
4. Anesthesiologist onsite direction of any non-physician who assists in the technical aspects of
anesthesia care to a patient

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