Specialized billing for anesthesiologists and anesthesia groups — base unit + time unit billing, CRNA supervision, and full anesthesia RCM. Serving practices nationwide across the United States.
Get Free Practice Audit Contact UsComprehensive billing coverage for your specialty
Accurate calculation and billing of base units plus time units for all surgical procedures across all payers and conversion factors.
Medical direction and supervision billing for CRNAs including proper QK, QX, QY, QZ modifier application.
Billing for chronic pain procedures including nerve blocks, epidural injections, spinal cord stimulators, and pain pump management.
Anesthesia denials for concurrent modifiers and time unit discrepancies are appealed with anesthesia records.
Accurate physical status modifier (P1-P6) application to capture qualifying circumstance units and maximize reimbursement.
Monthly anesthesia practice reports with per-case analysis, payer mix reporting, and conversion factor benchmarking.
Anesthesia is the only specialty whose payment is literally a formula: (base units + time units + modifying units) × a conversion factor. Every element of that formula has rules, and every rule has payer variations. Add medical-direction requirements, CRNA billing arrangements, and concurrency limits, and you get a specialty where billing accuracy isn't a back-office detail — it's the difference between profitable and underwater on the same caseload.
Every anesthesia CPT code carries assigned base units reflecting procedure complexity; time units are calculated from documented anesthesia start and stop — typically one unit per 15 minutes, but payers round differently and some pay in exact minutes. Sloppy time documentation is money evaporating in both directions: understated time is unbilled work, overstated time is an audit finding. We reconcile billed time against the anesthesia record on every case.
Who delivered the anesthesia — and how many cases concurrently — decides the payment split. Personally performed (AA), medical direction of CRNAs (QY/QK with the seven required attestation steps documented), medical supervision beyond four concurrent cases (AD), and non-medically-directed CRNA work (QZ) each pay differently and carry different documentation burdens. Concurrency errors are the classic anesthesia recoupment: one mistimed overlap can reclassify a whole day's cases. We audit concurrency from the schedule before claims go out.
P3–P5 physical status modifiers add units at many commercial payers (Medicare ignores them), and qualifying circumstances — extreme age, emergency conditions, hypothermia — add more. These small unit adders are chronically underbilled because they live in the pre-op assessment, not the billing sheet. Across thousands of cases a year, capturing them properly is a visible revenue line.
Many anesthesia groups run pain practices alongside the OR: epidural steroid injections, facet procedures, radiofrequency ablations, nerve blocks. This work bills as standard procedural coding — not the anesthesia formula — with its own prior authorization requirements, frequency limits, and medical necessity criteria that payers tightened sharply in recent years. Mixing the two billing models in one workflow without specialty knowledge is how pain revenue quietly leaks.
Labor epidurals follow their own payer-specific models — flat fees, capped time, or face-to-face time requirements — and billing them like surgical anesthesia produces systematic errors. We map each payer's OB methodology and bill to it, because a busy OB service on the wrong model can misprice hundreds of deliveries a year.
Specialties whose cases generate a paired anesthesia claim, where both claims have to tell the same story.
Many physicians hold the same board certification, and both lines run on time-based units and medical-direction concurrency rules.
Nearly every orthopedic case generates a paired anesthesia claim; base units and surgical modifiers must agree across both.
Endoscopy sedation is one of the highest-volume anesthesia lines, with its own monitored-anesthesia-care coverage rules.
Reconstructive cases need the anesthesia claim to carry the same medical-necessity story as the surgeon’s.
We bill all of these in house. If your group spans several of them, multi-specialty billing keeps one team across every line — or see the full list of services.
Get a free billing audit and see how much more your anesthesia practice can collect.
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