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29.2.4.9 Time-Based Fees
Reimbursement of time-based anesthesia services is defined as [(Minutes/15) + Relative Value Units (RVUs)] x Conversion Factor x Modifier Combination Adjustment = Anesthesia Reimbursement. It is derived from the following steps:
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1. Divide the total anesthesia time in minutes (the time of all procedures performed, directed or supervised) by 15. |
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2. Add the RVUs for the procedure performed (use the procedure with the highest RVUs when multiple procedures are performed at the same time). |
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3. Multiply this sum by the appropriate conversion factor. |
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4. Multiply this sum by the modifier combination adjustment percentage. |
Reimbursement of time-based fees requires documentation of exact time in minutes of face-to-face time with the client.
If anesthesia services are performed for two surgical procedures at separate times during the same date of service, both may be reimbursed based on the documentation submitted with the claim.
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