Practice Management FAQs - American Society of Anesthesiologists (ASA)

ASA members can frequently find complete answers to their questions by referring to materials posted or described on this website. They are urged to use this option before seeking specific advice from ASA staff. Staff priority will be given to member inquiries, and inquiries from nonmembers will be handled as expeditiously as other duties permit.

Is there a difference between "medical direction" and "supervision?"

Please send me the Medicare medical direction rules.

Where can I find out the truth about a JCAHO standard?

Do you have any information on contracts?

Do you have any information on anesthesia charges or payments?

What about anesthesiologists' salaries or compensation?

Do you have any information on benchmarking/productivity? E.g., what is the average number of cases per year?

What is the code / crosswalk for this procedure? How many units does it have?

Is there a difference between "medical direction" and "supervision?"
There is a difference in the Medicare payment rules. Medical direction requires the seven steps (like ASA policy) and pays 100 percent, split 50-50 between the M.D. and CRNA. Supervision applies when the anesthesiologist is involved in more than 4 cases concurrently, or when s/he doesn't meet all the requirements for medical direction. Payment for supervision is based on 3 units (plus one additional if the anesthesiologist participated in induction) for the MD, and the usual 50 percent for the CRNA.

Please send me the Medicare medical direction rules.
Medicare Carrier Manual Section 15018 can be downloaded here. (MS Word file)

Where can I find out the truth about a JCAHO standard?
Please visit the web site at: www.jcaho.org and/or the ASA JCAHO Compliance Toolkit.

Do you have any information on contracts?
Please see the list of ASA practice management publications available in our Publications Store section.

Do you have any information on anesthesia charges or payments?
The latest survey results were published in the July 2007 Newsletter.

What about anesthesiologists' salaries or compensation?
The Medical Group Management Association www.mgma.com publishes annual surveys with breakdowns by experience, size of group, academic/private, geographic region. Similar data are published periodically by the American Group Management Association www.amga.org and by the American Medical Association www.ama-assn.org (annual update of Physician Marketplace Statistics.)

Do you have any information on benchmarking/productivity? E.g., what is the average number of cases per year?
ASA member and Practice Management Committee Chair Amr Abouleish, M.D., M.B.A., has published several studies in Anesthesiology and in Anesthesia & Analgesia.

What is the code / crosswalk for this procedure? How many units does it have?
Please be sure to consult the current year's CPT-4™ (www.ama-assn.org ) and/or ASA Relative Value Guide® and/or ASA CROSSWALK®. Note that the ASA RVGTM and CROSSWALK® are guides only, and that payers or your own practice may use different systems.

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