[Code of Federal Regulations]

[Title 42, Volume 2]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR415.110]



[Page 796-797]

 

                         TITLE 42--PUBLIC HEALTH

 

                    CHAPTER IV--CENTERS FOR MEDICARE

                          & MEDICAID SERVICES,

                        DEPARTMENT OF HEALTH AND

                             HUMAN SERVICES

 

PART 415_SERVICES FURNISHED BY PHYSICIANS IN PROVIDERS, SUPERVISING 

PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS

--Table of Contents

 

      Subpart C_Part B Carrier Payments for Physician Services to 

                       Beneficiaries in Providers

 

Sec. 415.110  Conditions for payment: Medically directed anesthesia 

services.



    (a) General payment rule. Medicare pays for the physician's medical 

direction of anesthesia services for one service or two through four 

concurrent anesthesia services furnished after December 31, 1998, only 

if each of the services meets the condition in Sec. 415.102(a) and the 

following additional conditions:

    (1) For each patient, the physician--

    (i) Performs a pre-anesthetic examination and evaluation;

    (ii) Prescribes the anesthesia plan;



[[Page 797]]



    (iii) Personally participates in the most demanding aspects of the 

anesthesia plan including, if applicable, induction and emergence;

    (iv) Ensures that any procedures in the anesthesia plan that he or 

she does not perform are performed by a qualified individual as defined 

in operating instructions;

    (v) Monitors the course of anesthesia administration at frequent 

intervals;

    (vi) Remains physically present and available for immediate 

diagnosis and treatment of emergencies; and

    (vii) Provides indicated post-anesthesia care.

    (2) The physician directs no more than four anesthesia services 

concurrently and does not perform any other services while he or she is 

directing the single or concurrent services so that one or more of the 

conditions in paragraph (a)(1) of this section are not violated.

    (3) If the physician personally performs the anesthesia service, the 

payment rules in Sec. 414.46(c) of this chapter apply (Physician 

personally performs the anesthesia procedure).

    (b) Medical documentation. The physician alone inclusively documents 

in the patient's medical record that the conditions set forth in 

paragraph (a)(1) of this section have been satisfied, specifically 

documenting that he or she performed the pre-anesthetic exam and 

evaluation, provided the indicated post-anesthesia care, and was present 

during the most demanding procedures, including induction and emergence 

where applicable.



[63 FR 58912, Nov. 2, 1998]