Anesthesia Billing That Pays What You Earn
Anesthesia billing operates on a unique unit-based system that differs fundamentally from procedure-based medical billing. Base units, time units, qualifying circumstances, and physical status modifiers all combine to determine reimbursement — and a single error in any variable costs the practice on every single case. 360Solutions provides anesthesia billing specialists with expertise in TEFRA billing, medical direction rules, CRNA supervision ratios, and payer-specific conversion factor contracts.
Where Anesthesia Practices Lose Revenue
These are the coding and billing pitfalls that cost anesthesia practices the most — and where our specialised billers add the most value.
Base + Time Unit Calculation
Each anesthesia procedure has an ASA base unit value. Time units (1 unit per 15 minutes) are added, then multiplied by the conversion factor. Rounding errors, wrong time documentation, or incorrect base unit assignment costs money on every case.
Medical Direction Rules
Medicare's TEFRA rules govern how many CRNAs an anesthesiologist can medically direct (max 4 concurrent cases) and require documentation of 7 specific supervisory activities. Missing documentation converts medical direction to medical supervision — cutting reimbursement by 50%.
Physical Status Modifiers
ASA physical status modifiers (P1–P6) add units to the base value for higher-acuity patients. P3 adds 1 unit, P4 adds 2 units — but documentation must support the status assigned. Unsupported status modifiers trigger post-payment audit.
Qualifying Circumstances
Qualifying circumstances codes (99100–99140) apply to extreme age, emergency conditions, controlled hypotension, and total body hypothermia — adding units to the case value. These are frequently missed by non-specialist billers.
High-Risk CPT Groups
Code ranges payers audit most aggressively in Anesthesia.
Common Denial Patterns
Knowing these before submission is the difference between a 60% and a 96% first-pass rate.
Time units calculated incorrectly (rounding to nearest 15-min increment)
Medical direction modifier used without all 7 TEFRA activities documented
Physical status modifier not supported by documented comorbidities
Anesthesia claim submitted without start/stop times from anesthesia record
Concurrent case ratio exceeded under TEFRA (more than 4 CRNAs directed)
Send us your last 90 days of remittance data — we'll identify your top 3 fixable denial sources at no cost.
Request Free Audit →How 360Solutions Works for Anesthesia Practices
Free 2-Week Billing Audit
We review your last 90 days: denial breakdown by category, AR aging by payer, charge lag, collection rate, and any recurring coding issues specific to your specialty. No commitment required.
Specialty Coder Assignment
You are paired with a coder trained specifically in anesthesia coding. They learn your providers, your documentation patterns, and your payer mix before touching a claim.
Parallel Billing Transition
We run alongside your current billing for 10–14 days with zero cash flow disruption. Claims keep moving during the transition. Your account manager provides daily status updates.
Live KPI Dashboard
Real-time visibility into billed, paid, denied, AR aging, and collection rate — segmented by provider and payer. No black box, no month-end surprises.
Weekly Account Manager Call
Every week your dedicated account manager walks through last week's KPIs, denial trends, and any action items. Critical issues are escalated the same day — not at the next scheduled call.
Questions From Anesthesia Practices
Start With a Free,
No-Obligation Audit
Two weeks, no contract. A certified anesthesia billing specialist reviews your claims, denial patterns, and AR — and shows you exactly what is recoverable.