CurrentNeighborhood Health Plan of Rhode IslandPolicy N/A

Anesthesia Services Payment Policy – Archive 1

Defines Neighborhood Health Plan of Rhode Island reimbursement rules, billing, documentation and exclusions for anesthesia services across Medicaid (excluding EFP), INTEGRITY, and Commercial lines. Covers calculation of payment, included services in global anesthesia, caps for obstetrical anesthesia codes, coding lists, modifier payment percentages, and documentation/medical direction requirements.

Policy Summary

PayerNeighborhood Health Plan of Rhode Island

PolicyAnesthesia Services Payment Policy – Archive 1

Policy CodePolicy N/A

Change TypeArchive / Format updates

Effective Date

Next Review Date

Key ActionBill anesthesia claims under the rendering provider's name and NPI; do not submit base unit values in the time field.

SourceLink

POLICY UPDATE CHANGES

01/01/2023 Policy review: format change; removed General Billing Information; added language for General Documentation Requirements.

6/1/2014 CRNA credentialing requirements effective September 2014; CRNA billing and reimbursement requirements effective October 2014; clarifying billing and coding information.

5/1/2014 Format change; clarifying billing and coding information; epidural cap limits for 01967/01968 effective 8/1/2014; disclaimer updated.

9/1/2013 Format change only.

8/1/2011 Effective Date (original policy effective).

2Obstetrical codes with caps

00100-01999Anesthesia CPT range covered

7Medical direction required documentation items

Policy Summary

Background: Payment policy describes that anesthesia services include general anesthesia, regional anesthesia, supplementation of local anesthesia, and other supportive services provided to afford the patient optimal anesthesia care. Neighborhood follows CMS base unit values and CMS documentation standards, and reserves the right to request medical records and audit claims. Effective/last review: 01/01/2023.