As anesthesiologists and their practice administrators and billing departments know all too well, there is a very big difference between Medicare and commercial payers when it comes to payment for anesthesia services. The October 2021 edition of the ASA Monitor includes the results of the 2021 commercial conversion factor (CF) survey. Those results demonstrate that the gap between the Medicare anesthesia CF and the mean and median commercial CFs continues to widen. There are other differences as well, and we will discuss two of them in this column: Physical Status and Qualifying Circumstances.
Information about physical status assignment is included in the ASA statement titled “ASA Physical Status Classification System.” That document provides examples to guide the anesthesiologist in determining a patient's physical status as a clinical judgment. There are also billing and payment implications that are covered in the ASA Relative Value Guide® (RVG™). Medicare does not recognize...
