Medicare has determined that providers are not routinely billing with modifiers AD and 23 when performing more than four concurrent anesthesia procedures.
Payment is allowed for three base units per procedure when an anesthesiologist is involved in furnishing more than four anesthesia procedures concurrently, or when an anesthesiologist is performing other services while directing the concurrent procedures. An additional time unit is allowed only if the documentation supports the physician was present at induction.
When billing for more than four concurrent anesthesia procedures, and to ensure proper payment, please follow these guidelines.
Medicare does not pay for more than three base units unless the anesthesia procedure is billed with modifiers AD and 23. Payment for claims submitted with modifier AD only will be made for three base units.