Optum has clarified its payment policy for anesthesia services provided during electroconvulsive therapy, confirming that such services are eligible for separate reimbursement under certain conditions, according to a June 10 news release from the American Society of Anesthesiologists.
Optum acknowledged that anesthesia services are a medically necessary and clinically distinct component of ECT, but noted that reimbursement depends on whether a facility operates under a bundled or unbundled payment arrangement. In bundled arrangements, the facility payment includes anesthesia services and the facility is responsible for compensating clinicians.
In unbundled arrangements, anesthesia services may be billed and paid separately. Optum also clarified that CPT codes 00104 and 90870 may not be billed together when submitted by the same physician specialty, but may both be reported when anesthesia and ECT services are performed by different physician specialties.
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