# medicare and anesthesia concurrency



## khill (Oct 28, 2009)

I'm wondering if anyone can tell me the proper way to bill for an anesthesiologist who runs over 4 concurrent cases when it comes to billing medicare. Is the charge then given to the crna? Or is it charged normally at a reduced billing rate?


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## jdrueppel (Oct 28, 2009)

More than 4 concurrent cases becomes "medical supervision".  See below excerpt from the Medicare Provider Manual.  I have attached the link for full information.  See Section 50.

D. Payment at Medically Supervised Rate
Carriers may allow only three base units per procedure when the anesthesiologist is involved in furnishing more than four procedures concurrently or is performing other services while directing the concurrent procedures. An additional time unit may be recognized if the physician can document he or she was present at induction

http://www.cms.hhs.gov/manuals/downloads/clm104c12.pdf

Julie, CPC


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