Monitored Anesthesia Care
Monitored anesthesia care involves intraoperative monitoring by a physician or qualified
individual under the medical direction of a physician or of the patient’s vital physiological signs
in the anticipation of the need for administration of general anesthesia or of the development of
adverse physiological patient reaction to the surgical procedure. It also includes the performance
of a pre-anesthetic examination and evaluation, prescription of anesthesia care required,
administration of any necessary oral or parenteral medications (e.g., atropine, demerol, valium)
and provision of indicated post-operative anesthesia care.
Payment is made under the personally performed rate if the physician personally
performs the monitored anesthesia care (see Payment at Personally Performed Rate).
Payment is made under the medically directed payment rate if the physician medically
directs four (4) or fewer concurrent cases and the monitored anesthesia care represents
one (1) or more of these concurrent cases (see Payment at Medically Directed Rate).
Pain Management
Pain Management Consultation
Evaluation and management services for postoperative pain control on the day of surgery are
considered part of the usual anesthetic services and are not separately reportable. When
medically necessary and requested by the attending physician, hospital visits or consultative
services are reportable by the anesthesiologist during the postoperative period. However, normal
postoperative pain management, including management of intravenous patient controlled
analgesia, is considered part of the surgical global package and should not be separately
reported.
