OB anesthesia can be a make-or-break service for an anesthesia practice. It should also be noted that the clinical and financial review of surgical anesthesia payments should never be comingled with labor payments because, not only are the payment methodologies different, but the payer mix is sure to be very different. It is payment for obstetrical anesthesia that most confuses and frustrates our clients because of all the arcane nuances embedded within the charge and payment calculation. Non-time-based services are all paid based on the payer’s fee schedule, not ASA units. Health plans tend to have policies that pay a contracted rate per unit for surgical anesthesia, including c-sections. Its unique aspects, including (a) the use of epidurals that don’t require continuous attention, (b) the ability to manage multiple cases simultaneously, and (c) complex, diverse and inconsistent billing rules, make it a subject for special consideration.įrom a billing perspective, all anesthesia charges fall into three categories: time-based surgical anesthesia, obstetric (OB) analgesia and non-time-based charges, such as those for invasive monitoring, nerve blocks, ultrasonic guidance and visit codes. Obstetric anesthesia is either a make-or-break service for anesthesia practices.
