Financial opportunities in anesthesia flat-fee services

The American Society of Anesthesiologists' 2020 update of its Relative Value Guide has new updates that affect the way flat-fee services are billed. A blog post by Tony Mira, founder of MiraMed's Anesthesia Business Consultants, detailed a potential financial opportunity in these changes. 

Non-time-based services, like flat fees and some obstetric anesthesia services, are paid on a fee schedule. Nerve blocks, a non-time-based service, have seen a dramatic increase in numbers performed in the past few years, which has resulted in a significant increase in revenue for some anesthesia practices.

The diversity of rates in flat-fee services, which Mr. Mira outlined in his post, comes from practitioners not performing many nerve blocks for acute pain management.

The ASA has changed the way flat-fee services are billed, Mr. Mira said, which is a reflection of how a majority of anesthesia contracts with payers specify an anesthesia unit rate. But increasingly, flat-fee services default to some percentage of Medicare rates. 

Anesthesia practices often neglect to request reasonable payment for their flat-fee service, and this request could be a revenue opportunity — especially if they perform blocks routinely.

Flat-fee services, such as nerve blocks, represent additional financial benefit on existing surgical volume, Mr. Mira said. Taking full financial advantage of the opportunity requires that the practice's contracting strategy takes them into consideration to negotiate reasonable fee schedules.

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