Anesthesia reimbursements keep plummeting

ASCs are facing major obstacles to securing anesthesia coverage, and the decline in reimbursements is exacerbating the issue. 

Here are six notes about the decline of reimbursements:

1. The average anesthesia reimbursement rate for 2023 was $21.88, a 5.5% decline from 2019, according to a Jan. 16 blog post from Coronis Health. 

2. If an anesthesia provider generates 10,000 billable units from Medicare, the total revenue potential is only $218,000, the report added, assuming that all revenue could be collected. 

3. Medicare reimbursements for anesthesia services decreased from $22.2730 per unit in 2019 to $21.1249 in 2023, according to a VMG Report

4. Additionally, according to the VMG report, the No Surprises Act and its independent dispute resolution process have "led to unintended consequences for anesthesia providers," and the IDR process has been used by payers to "reduce reimbursement by refusing to go in network with anesthesia providers."

5. In March 2023, Cigna announced it was lowering the reimbursements for non-medically directed procedures performed by certified registered nurse anesthetists by 15%. Cigna lowered its reimbursement for claims submitted with the QZ modifier, which indicated a non-medically directed CRNA service.

6. Over the last 23 years, the inflation-adjusted Medicare reimbursement for the selected pain management procedures decreased annually by 2.81%, according to a February report from American Association of Physician Leadership. 

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