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US · guidance

CMS Pub. 100-04, ch. 12, § 140.4.1

An Anesthesiologist and Qualified Nonphysician Anesthetist

activein force · 2026-08-25 – presentas-observed

Work Together

(Rev. 3747; Issued: 04-14-17; Effective: 01-01-17; Implementation: 05-15-17)

A/B MACs will distribute educational releases and use other established means to

ensure that anesthesiologists understand the requirements for medical direction of

qualified nonphysician anesthetists.

A/B MACs will perform reviews of payments for anesthesiology services to identify

situations in which an excessive number of concurrent anesthesiology services may

have been performed. They will use peer practice and their experience in developing

review criteria. They will also periodically review a sample of claims for medical

direction of four or fewer concurrent anesthesia procedures. During this process

physicians may be requested to submit documentation of the names of procedures

performed and the names of the anesthetists medically directed.

Physicians who cannot supply the necessary documentation for the sample claims must

submit documentation with all subsequent claims before payment will be made.

History

(Rev. 3747; Issued: 04-14-17; Effective: 01-01-17; Implementation: 05-15-17)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
b12e96b5e1840a370629925208e49dd4e36087450c0c4caf76e9a51e9e78d6fe
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