Medicare pays physicians for medical direction of nurse anesthetists at 50 percent of the reimbursement they would receive if they performed the work alone. CMS says physicians will be paid for medical direction of two to four concurrent cases provided they:
1. Perform a pre-anesthetic examination and evaluation and document it in the medical record.
2. Prescribe the anesthesia plan.
3. Personally participate in the most demanding procedures in the anesthesia plan —including induction and emergence, if applicable — and document this.
4. Ensure that any procedures in the anesthesia plan are performed by a qualified anesthetist.
5. Monitor the course of anesthesia administration at frequent intervals and document that they were present during some portion of the anesthesia monitoring.
6. Remain physically present and available for immediate diagnosis and treatment of emergencies.
7. Provide indicated-post-anesthesia care and document it.
Source: CMS