Anesthesia Coding Alert

Question: One of our anesthesia providers is a CRNA, and we do the billing for her. When she was gone recently, she hired a locum tenens CRNA to fill in for her. The locum tenens CRNA is not credentialed with Medicare in Indiana, where we are located. Our CRNA says the locum CRNA doesn’t need a provider number; that under their agreement, we can bill our CRNA’s Medicare number in box 24K and put her name on the claim. Is that correct?

Indiana Subscriber

Answer: That is not correct. A certified registered nurse anesthetist (CRNA) who isn’t a registered Medicare provider with the state where they are providing the service cannot file a claim under another CRNA’s name. The Centers for Medicare & Medicaid Services (CMS) does not allow CRNAs to report reciprocal or locum tenens billing; these types of reporting are only applicable to physicians. The locum CRNA must apply for an Indiana provider number and reassign benefits to your practice before you can bill using their name.

Note: During the COVID-19 public health emergency (PHE), there were waivers in place that modified both fee-for-time compensation (locum tenens) and reciprocal billing arrangements for physicians; however, it did not apply to non-physician practitioners.