Provider Central

This article is for professional and facility providers who administer anesthesia

Blue Cross reimburses for anesthesia services as outlined in our existing Anesthesia payment policy().

As a reminder, there are several statements in the policy that describe how we pay claims. These include (but are not limited to):

• When anesthesia services are provided for multiple surgical procedures, only report the anesthesia code for the most complex service (with the highest base value) with the total time for all procedures performed.
• Blue Cross does not reimburse an E/M visit on the same day, the day before, or one day after the reporting of an anesthesia service.
• Blue Cross reimburses general anesthesia performed by the anesthesia provider, or under the anesthesiologist’s medical direction, at a rate not to exceed 100 percent of the anesthesia service allowable amount.
• Blue Cross does not recognize the use of revenue code 964.

Payment policy application

• Enforcement of this payment policy occurs through system edits and post-payment reviews.
• We continually expand our ability to process claims in accordance with this policy pre-payment, which will reduce the number of claims we review post-payment.

Important billing reminders

• Bill all anesthesia codes with the appropriate revenue code according to our policy.
• Bill multiple anesthesia services on a single line using the code with the highest base rate. List the total units for all anesthesia services.
• Blue Cross does not reimburse more than 100 percent of the allowed amount for the service.

Resources

Anesthesia payment policy (see the policy for additional billing guidelines). To download this payment policy, log in and click Find a Payment Policy on the right side of your home page. Or, go to Office Resources>Policies & Guidelines>Payment Policies.

MPC_060921-2L-1