CPT 00104: Anesthesia for Electroconvulsive Therapy
CPT code 00104 represents anesthesia services furnished during electroconvulsive therapy (ECT). Nationally, accurate use of this CPT code ensures appropriate classification of anesthesia care tied to a commonly performed psychiatric therapeutic procedure that requires brief general anesthesia or deep sedation. Correct coding affects claims processing, clinical documentation, and aggregated reporting for anesthesia utilization in mental health treatment.
Key payers referenced in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. The publication outlines who covers this service, common billing practices, and contextual clinical considerations tied to ECT anesthesia.
Readers will find a concise benchmarks and policy overview that covers standard clinical context for CPT code 00104, payer coverage considerations, and related anesthesia code relationships for peri-procedural classification. The report highlights where coding alignment matters for procedural setting designation (inpatient vs outpatient), and it summarizes related anesthesia service codes for comparative reference. Data not available in the input will be noted where applicable.
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Billing Code Overview
CPT code 00104 describes anesthesia services provided for a patient undergoing electroconvulsive therapy. The service type is anesthesia for electroconvulsive therapy, and the typical site of service is an inpatient or outpatient procedural setting where electroconvulsive therapy is performed, such as a hospital operating room, procedure suite, or specialized psychiatric ECT suite.
National Reimbursement Benchmarks
National commercial rates for CPT 00104 center around BUCA’s mean of $80.6 as an average commercial benchmark, with individual payers displaying meaningful dispersion. Blue Cross Blue Shield’s interquartile spread (P75–P25 = $96.50 - $53.70) is $42.80, Aetna’s spread ($123.80 - $55.00) is $68.80, Cigna’s spread ($108.10 - $67.60) is $40.50, and UnitedHealth Group’s spread ($81.40 - $52.00) is $29.40. These spreads indicate variability in negotiated commercial pricing relative to the BUCA average.
UnitedHealth Group shows the tightest IQR at $29.40, suggesting more concentrated commercial rates, while Aetna has the widest IQR at $68.80, indicating greater variability among contracted rates. Blue Cross Blue Shield and Cigna fall between those extremes with IQRs of $42.80 and $40.50 respectively, framing the market variability around BUCA’s mean.