Ever Wonder How Anesthesia Gets Paid?
A crash course in base units and 15-minute increments of time.
E
ver wonder
how anesthe-
sia providers
are paid? Most of us
are salaried or are
paid hourly, but it's
good for facility man-
agers to know how
the folks at the head
of the table bill insur-
ers for our services — and what factors make a facility a desirable
place for us to work. Let's start with how anesthesia is billed: in base
units and time units.
• Base units. These are the numeric value attached to each CPT
code. They cover the pre-operative interview, and generally factor in
complexity and risk. Anesthesia for a laparoscopic cholecystectomy is
valued at only 7 base units, while a coronary artery graft without car-
diopulmonary bypass is valued at 25 base units.
• Time units. These are generally in 15-minute increments. They
start the moment a provider enters the OR and stop the moment he
gives a report to the PACU nurse.
There are some exceptions, but generally, if a case has 6 base units
and takes 60 minutes, you'd bill for a total of 10 units (6 base + 4
time). The ASA Relative Value Guide lists the number of base units for
each case. Check the area of the body having the procedure and look
under the list of codes. For example, cataract surgery falls under "pro-
cedures on the eye" and 00142 is anesthesia for lens surgery (4 base
units plus time units).
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Anesthesia Alert
Mike MacKinnon, MSN, FNP-C, CRNA
• MEDICAL ECONOMICS Do you understand how anesthesia is billed?
