CMS temporarily relaxes physician supervision rules for CRNAs: 5 things to know

In early April, CMS temporarily waived physician supervision requirements for certified registered nurse anesthetists due to the COVID-19 pandemic, according to Anesthesia Business Consultants President and CEO Tony Mira.

Five things to know:

1. As used within the federal conditions of participation, the term "supervision" means that a physician is immediately available to the CRNA in case a problem arises.

2. ABC interpreted the waiver to mean all states are being treated as "opt-out" states concerning the CRNA supervision rule. Several states have already been opting out of the physician supervision requirement, as permitted under a provision of the federal conditions of participation.

3. The waiver may not override state rules or regulations requiring physician supervision of CRNAs.

4. Medical direction rules remain in place for groups following that model for CRNA supervision. The modifiers QZ and QK should still be used to denote the presence or absence of medical direction.

5. The CMS waiver does not mean all cases involving CRNAs must be billed with the QZ modifier.


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