BCBS - Anesthesia Modifier reimbursement

Anesthesia Payment & Billing Information - BCBS

Anesthesia Modifier Reimbursement :


Effective for dates of service on or after May 19, 2004, the HMO Blue Texas and Blue Cross and Blue Shield of Texas maximum allowable fees for services billed as MD supervision of a CRNA are as follows:


QY MD supervision of a CRNA $325.52
QK MD supervision of a CRNA $310.01
AD MD supervision of a CRNA $162.76


OB Time and Points Maximum Allowable Points :

The following are the current HMO Blue Texas and Blue Cross and Blue Shield of Texas total maximum allowable points for Vaginal or Cesarean deliveries:
                   Obstetrical Vaginal delivery: 23 total maximum allowable points
                   Obstetrical Cesarean delivery: 32 total maximum allowable points
If general anesthesia is used in the performance of any obstetrical Vaginal or Cesarean delivery, the maximum allowable points are applicable. In the event that total actual points are less than the total maximum allowable points, you will be reimbursed based on total actual points.

Reimbursement of OB Anesthesia Add-On Codes 01968 and 01969 :

When a primary OB delivery anesthesia procedure (01967) is billed with either 01968 and/or 01969, HMO Blue Texas and Blue Cross and Blue Shield of Texas allows a combined maximum of 32 points.