Georgia Medicare Anesthesia Services

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Georgia Medicare Anesthesia Services

By Brevy Care Team · Last verified May 13, 2026

Section 1861(s)(1) of the Social Security Act covers physician anesthesia services under Medicare Part B. Section 1861(s)(11) and Section 1861(bb), established by Section 9320 of the Omnibus Budget Reconciliation Act of 1986 (OBRA 1986), recognize Certified Registered Nurse Anesthetist (CRNA) services as a separately reimbursable benefit effective January 1, 1989. The implementing regulation at 42 CFR 410.69 specifies CRNA and Anesthesiologist's Assistant (AA) coverage conditions. Anesthesia services are paid using a unit-based methodology under 42 CFR 414.46: base units from the American Society of Anesthesiologists Relative Value Guide, plus time units (one unit per 15 minutes), multiplied by the locality-adjusted anesthesia conversion factor. Section 4511 of the Balanced Budget Act of 1997 standardized the conversion factor methodology. The TEFRA seven conditions at 42 CFR 415.110 govern when an anesthesiologist may bill medical direction modifiers (QK, QY) at 50 percent while the CRNA bills the matching modifier (QX) at the other 50 percent. The 42 CFR 482.52(c) opt-out provision, created under BBA 2001 authority, allows state governors to opt out of the federal CRNA physician supervision requirement at 42 CFR 482.52(a)(4). As of 2026, 17 states plus territories have opted out. Georgia has NOT opted out. This guide explains how every layer of the framework operates, how anesthesia is billed in Atlanta versus Savannah versus rural locality settings, what beneficiaries owe under Original Medicare versus Medicare Advantage, and how Georgia Medicare beneficiaries access anesthesia services across the state. :::

::: callout Key Takeaways

1. Section 1861(s)(1) of the Social Security Act covers physician anesthesia services. Section 1861(s)(11) and Section 1861(bb), added by OBRA 1986 Section 9320, established CRNA services as a separately reimbursable benefit effective January 1, 1989.
2. Anesthesia services are paid using a unit-based methodology (not the standard RBRVS used for most physician services): payment equals base units plus time units multiplied by the locality-adjusted anesthesia conversion factor.
3. Base units come from the American Society of Anesthesiologists Relative Value Guide and range from 3 for minor procedures to 30 for liver transplantation. Time units equal one unit per 15 minutes of anesthesia time.
4. The TEFRA seven conditions at 42 CFR 415.110 govern medical direction: when an anesthesiologist meets all seven conditions for up to four concurrent CRNA cases, the team bills 50/50 (QK or QY by the anesthesiologist, QX by the CRNA), totaling 100 percent of the unit-based payment.
5. The 42 CFR 482.52(c) opt-out provision, created under BBA 2001 authority, allows state governors to opt out of the federal CRNA physician supervision requirement. As of 2026, 17 states plus territories have opted out. Georgia has NOT opted out.
6. Anesthesia modifiers indicate who delivered the service and the supervision arrangement: AA (anesthesiologist personally performed, 100 percent), QK (anesthesiologist medical direction of 2 to 4 concurrent cases, 50 percent), QY (anesthesiologist medical direction of 1 CRNA case, 50 percent), QX (CRNA with medical direction, 50 percent), QZ (CRNA without medical direction, 100 percent), AD (medical supervision of more than 4 cases, reduced payment).
7. Beneficiaries owe 20 percent Part B coinsurance after the annual deductible. Medicare Supplement Plans G and N cover the 20 percent coinsurance. Cost-sharing is waived for anesthesia furnished during screening colonoscopy under ACA Section 4104 and BBA 2018 Section 53113.
8. Georgia has approximately 2,800 anesthesiologists and 2,400 CRNAs as of 2026, concentrated in metro Atlanta. Rural Critical Access Hospitals rely heavily on CRNA practice under operating-surgeon supervision (required because Georgia has not opted out). :::

The Statutory and Regulatory Architecture

Medicare anesthesia services rest on a layered framework that combines four sets of authorities: the underlying physician services benefit category in Section 1861(s)(1), the separate CRNA benefit established by OBRA 1986 Section 9320 and codified at Section 1861(s)(11) and Section 1861(bb), the unit-based payment methodology at 42 CFR 414.46, and the supervision and medical direction rules at 42 CFR 482.52 and 42 CFR 415.110. Understanding how these pieces interact is essential for beneficiaries who want to make sense of their anesthesia bills.

Section 1861(s)(1): The Physician Services Foundation

Section 1861(s)(1) of the Social Security Act establishes "physicians' services" as a covered benefit under Medicare Part B. Anesthesia services personally performed or medically directed by an anesthesiologist (a physician licensed as MD or DO and trained in anesthesiology) fall within this benefit category. Before OBRA 1986 expanded the framework to recognize CRNAs separately, all anesthesia furnished in a hospital was bundled into the hospital's payment, and physician anesthesia was billed under Part B by the anesthesiologist. Section 1861(s)(1) remains the statutory foundation for anesthesiologist billing today.

OBRA 1986 Section 9320: Establishing the CRNA Benefit

Public Law 99-509, signed October 21, 1986, restructured Medicare in numerous ways. Section 9320 of that statute added a new clause to the list of covered services in Section 1861(s)(11) recognizing "qualified anesthetist services," and added a new defined term at Section 1861(bb) specifying what a "qualified anesthetist" means. The effective date for the new benefit was delayed until January 1, 1989, to allow CMS to promulgate implementing regulations.

Before OBRA 1986 Section 9320, CRNA services were not separately reimbursable by Medicare. In hospital settings, CRNA labor cost was bundled into the diagnosis-related group (DRG) hospital payment. In nonhospital settings, CRNAs typically billed under an anesthesiologist's NPI or were not paid by Medicare at all. The OBRA 1986 reform unbundled CRNA services and created a direct billing pathway. This change had two profound effects on access to anesthesia in rural America: it gave CRNAs an economic identity independent of physician anesthesiologists, and it enabled rural hospitals (which often could not recruit anesthesiologists) to operate surgical programs with CRNA-led anesthesia.

Section 1861(bb): The CRNA Definition

Section 1861(bb) defines a "qualified anesthetist" as a Certified Registered Nurse Anesthetist licensed by the state in which the services are furnished, who has the qualifications described in regulations promulgated by the Secretary of HHS. The implementing regulation at 42 CFR 410.69 specifies these qualifications: graduation from a nurse anesthesia program accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs, certification by the National Board of Certification and Recertification for Nurse Anesthetists, and an unrestricted state nursing license.

42 CFR 410.69: CRNA and AA Coverage Conditions

The regulation at 42 CFR 410.69 sets out the substantive conditions of coverage for CRNA services and for Anesthesiologist's Assistant services. Coverage is available when the services are furnished by a CRNA or AA who meets the regulatory definition, when the services are furnished in the United States, when the CRNA or AA is legally authorized to perform the services under state law in the state where they are furnished, and when the services would be covered if furnished by a physician. The same regulation defines an Anesthesiologist's Assistant as a graduate of an accredited AA program, certified by the National Commission on Certification of Anesthesiologist Assistants, working under the direction of an anesthesiologist.

Anesthesiologist's Assistants are recognized in approximately 18 states, including Georgia. Unlike CRNAs (who in opt-out states may practice without physician supervision), AAs always require anesthesiologist supervision under state and federal law. Georgia's recognition of the AA profession reflects the state's deep ties to Emory University, which operates one of the few AA training programs in the country.

42 CFR 414.46: The Anesthesia Conversion Factor

The regulation at 42 CFR 414.46 establishes the unit-based payment methodology for anesthesia services. Unlike most physician services, which are paid using the Resource-Based Relative Value Scale (RBRVS) with separate work, practice expense, and malpractice components, anesthesia uses a simpler formula:

Payment = (Base Units + Time Units + Modifying Units) × Anesthesia Conversion Factor × Modifier Percentage

Each component reflects a distinct dimension of the service:

• Base units come from the American Society of Anesthesiologists Relative Value Guide and reflect the complexity of the anesthesia service. The simplest procedures (cataract extraction, minor outpatient surgery) carry 3 to 4 base units. Major procedures (coronary artery bypass graft, open abdominal aortic aneurysm repair, liver transplant) carry 15 to 30 base units.
• Time units equal one unit per 15 minutes of anesthesia time, rounded to one decimal place. A 90-minute case yields 6.0 time units. A 47-minute case yields 3.13 time units.
• Modifying units account for physical status modifiers and qualifying circumstances. Medicare does NOT pay additional units for physical status (commercial payers often do).
• Anesthesia conversion factor is set annually by CMS and adjusted geographically using the Geographic Practice Cost Index. For Georgia in 2026, the Atlanta locality conversion factor is approximately $22.45, and the rest-of-Georgia conversion factor is approximately $21.95.
• Modifier percentage reflects who delivered the service and the supervision arrangement, ranging from 100 percent (AA personally performed, QZ CRNA without medical direction) to 50 percent (medical direction modifiers).

42 CFR 415.110: The TEFRA Seven Conditions for Medical Direction

The Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA) introduced the framework that is today codified at 42 CFR 415.110. Under this regulation, an anesthesiologist may bill medical direction modifiers (QK for 2 to 4 concurrent cases, QY for 1 concurrent CRNA case) only if the anesthesiologist personally satisfies all seven of the following conditions for each case:

1. Performs a pre-anesthetic examination and evaluation of the patient
2. Prescribes the anesthesia plan
3. Personally participates in the most demanding procedures of the anesthesia plan, including (where applicable) induction and emergence
4. Ensures that any procedures in the anesthesia plan that the anesthesiologist does not personally perform are performed by a qualified anesthetist
5. Monitors the course of anesthesia administration at frequent intervals
6. Remains physically present and available for immediate diagnosis and treatment of emergencies
7. Provides indicated post-anesthesia care

When all seven conditions are satisfied for each of up to four concurrent cases, the anesthesia care team bills 50/50: the anesthesiologist bills QK (for 2 to 4 cases) or QY (for 1 case) at 50 percent of the unit-based payment, and the CRNA bills QX at the other 50 percent. The team's combined reimbursement equals 100 percent of the unit-based payment, the same amount Medicare would pay for an anesthesiologist personally performing the case (AA modifier).

If the anesthesiologist directs more than four concurrent cases, the case mix is considered "medical supervision" rather than "medical direction," the modifier is AD, and the payment is substantially reduced (3 base units plus 1 time unit per case for the anesthesiologist's portion, instead of 50 percent of the full unit-based payment).

42 CFR 482.52: Hospital Anesthesia Conditions of Participation

The regulation at 42 CFR 482.52 sets out the Conditions of Participation for anesthesia services in Medicare-certified hospitals. Section 482.52(a)(4) lists the categories of practitioner authorized to administer anesthesia: an anesthesiologist, an MD or DO other than an anesthesiologist, a qualified dentist or oral surgeon, a podiatrist (where state law authorizes podiatry anesthesia), a CRNA "under the supervision of the operating practitioner or of an anesthesiologist who is immediately available if needed," and an Anesthesiologist's Assistant "under the supervision of an anesthesiologist who is immediately available if needed."

The key phrase for non-opt-out states is the CRNA supervision requirement: a CRNA must work "under the supervision of the operating practitioner" (typically the operating surgeon) "or of an anesthesiologist who is immediately available if needed." This is a Conditions of Participation requirement that applies to the hospital, not a Part B billing requirement. The operating surgeon need not actively direct the CRNA; the surgeon need only be the supervising practitioner of record. The CRNA can still bill QZ (CRNA without medical direction) if no anesthesiologist medically directs the case; QZ refers to the absence of anesthesiologist medical direction (a billing concept), not the absence of surgeon supervision (a Conditions of Participation concept).

42 CFR 482.52(c): The State CRNA Supervision Opt-Out

Effective November 13, 2001, the final rule promulgated at 42 CFR 482.52(c) created a state opt-out mechanism. To opt out of the federal CRNA physician supervision requirement, a state's governor must (1) consult with the State Boards of Medicine and Nursing, (2) determine that opting out is consistent with state law, (3) conclude that opting out is in the best interest of state citizens, and (4) submit a letter to the CMS Regional Office.

As of 2026, the following 17 states and territories have opted out:

Georgia has NOT opted out. Therefore CRNAs practicing in Georgia Medicare-certified hospitals and ambulatory surgical centers must comply with the federal supervision requirement at 42 CFR 482.52(a)(4): supervision by the operating practitioner or by an anesthesiologist who is immediately available. The supervising physician need not be an anesthesiologist; the operating surgeon, dentist, or podiatrist qualifies for non-opt-out states.

BBA 1997 Section 4511: Conversion Factor Methodology

Section 4511 of the Balanced Budget Act of 1997 (Public Law 105-33) refined the methodology for setting the anesthesia conversion factor. Before BBA 1997, anesthesia conversion factor updates were handled on an ad hoc basis. The BBA 1997 reform standardized the calculation, tied conversion factor updates to the Medicare Economic Index, and aligned the geographic adjustment methodology with the broader Physician Fee Schedule Geographic Practice Cost Index.

The conversion factor reflects three component costs:

• Work component (the anesthesia provider's professional labor)
• Practice expense component (overhead, staff, equipment)
• Malpractice component (professional liability insurance)

Each component is multiplied by the locality-specific Geographic Practice Cost Index value and combined into a single per-unit dollar amount. For Georgia, two localities exist: Atlanta (a high-cost urban locality) and Rest of Georgia (a lower-cost locality covering all counties outside the Atlanta MSA boundary).

BBA 2001 and the Opt-Out Authority

Section 532 of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA, often informally called BBA 2001) provided the authority for CMS to create the state opt-out mechanism that became 42 CFR 482.52(c). The final rule was published November 2001 and went into effect immediately. Litigation challenging the rule (filed by the American Society of Anesthesiologists and other parties) was ultimately unsuccessful, and the opt-out framework remains in effect as written.

Anesthesia Billing Modifiers

Medicare requires specific modifiers to indicate who provided anesthesia services and the supervision arrangement. Understanding the modifier system is essential for interpreting anesthesia bills:

Common Billing Combinations

Personally performed (AA): An anesthesiologist provides all anesthesia care personally. Anesthesiologist bills AA at 100 percent.

Medical direction of 1 CRNA (QY + QX): An anesthesiologist medically directs one CRNA case, meeting all seven TEFRA conditions. Anesthesiologist bills QY at 50 percent; CRNA bills QX at 50 percent. Total = 100 percent.

Medical direction of 2 to 4 concurrent CRNAs (QK + QX): An anesthesiologist medically directs 2, 3, or 4 concurrent CRNA cases, meeting all seven TEFRA conditions for each. Anesthesiologist bills QK at 50 percent; each CRNA bills QX at 50 percent. Total per case = 100 percent.

Medical supervision of more than 4 concurrent cases (AD): An anesthesiologist supervises more than four concurrent cases. Anesthesiologist bills AD, which pays only 3 base units plus 1 time unit per case (substantially less than 50 percent). CRNAs in this arrangement bill QX at 50 percent.

CRNA without medical direction (QZ): A CRNA provides anesthesia care without anesthesiologist medical direction. CRNA bills QZ at 100 percent. In opt-out states, no physician supervision is required. In non-opt-out states like Georgia, the CRNA must still be supervised by the operating practitioner under 42 CFR 482.52(a)(4) (a Conditions of Participation requirement), but supervision by the operating surgeon does not change the billing modifier from QZ to QX. QX applies only when an anesthesiologist medically directs the case under the TEFRA seven conditions.

ASA Relative Value Guide Base Units

The American Society of Anesthesiologists publishes the Relative Value Guide (RVG) annually. CMS adopts the ASA RVG base units for Medicare payment. Representative examples for common surgical anesthesia services:

Anesthesia CPT codes (00100 through 01999) are different from surgical CPT codes. Each anesthesia code maps to one or more surgical codes via the ASA Crosswalk, which is updated annually.

Time Units Calculation

One time unit equals 15 minutes of anesthesia time, calculated from the moment the anesthesia provider begins to prepare the patient for anesthesia care in the operating room or equivalent area, and continuing until the patient may be safely placed under postoperative supervision. Anesthesia time is rounded to one decimal place.

Examples:

• 30 minutes = 2.0 time units
• 47 minutes = 3.13 time units
• 105 minutes = 7.0 time units
• 320 minutes = 21.33 time units

Anesthesia time is NOT the same as surgical time. Anesthesia time starts before the surgeon makes the incision (when the anesthesia provider begins preparing the patient) and ends after the surgeon closes (when the patient is safely transferred to recovery). Anesthesia time is typically 20 to 30 minutes longer than surgical time.

Physical Status Modifiers

The ASA Physical Status (PS) classification rates patient acuity from P1 (normal healthy patient) to P6 (declared brain-dead patient whose organs are being removed for transplantation):

Medicare does NOT pay additional units for physical status modifiers. Commercial payers and some Medicare Advantage plans do pay additional units, so providers continue to document and bill the PS modifier even though Medicare ignores it for payment.

Beneficiary Cost-Sharing

Anesthesia services follow standard Medicare Part B cost-sharing:

• Annual Part B deductible: $278 in 2026
• Coinsurance: 20 percent of the Medicare-approved amount after deductible
• Medicare Supplement Plans G and N typically cover the 20 percent coinsurance after the Part B deductible is met
• Medicare Advantage plans may charge specialist copay or percentage coinsurance per surgical episode (typically $0 to $50 per surgery in addition to facility copay)

Screening Colonoscopy Anesthesia Cost-Sharing

Anesthesia furnished during a screening colonoscopy is treated as part of the preventive screening benefit under ACA Section 4104 (Public Law 111-148) and the BBA 2018 Section 53113 phased reduction of cost-sharing for screening colonoscopies that become diagnostic due to polypectomy. Effective January 1, 2022, beneficiary coinsurance for the related anesthesia begins phasing down toward zero by 2030. As of 2026, the beneficiary coinsurance for screening colonoscopy anesthesia is reduced to approximately 10 percent (declining further each year through the phase-in schedule). The standard Part B deductible may also be waived for the screening procedure depending on plan and year.

Medicare Supplement Coverage of Anesthesia

Plan G is the most comprehensive Medigap plan available to newly eligible beneficiaries (Plan F is no longer available to those who became eligible on or after January 1, 2020). Plan G covers everything Plan F covers except the Part B deductible:

• Part A deductible
• Part B coinsurance (the 20 percent for anesthesia)
• Part B excess charges (the 15 percent above Medicare-approved amount that providers may charge if they do not accept assignment)
• Skilled nursing facility coinsurance
• First three pints of blood
• Foreign travel emergency

Plan N is a lower-premium alternative that covers the same items as Plan G with two exceptions: a $20 office-visit copay and a $50 emergency room copay (waived if admitted). Plan N does NOT cover Part B excess charges. For anesthesia services, Plan N and Plan G provide equivalent coverage because anesthesia is not an office visit or an emergency room visit, and almost all anesthesiologists and CRNAs accept Medicare assignment.

Anesthesia Care Team Model

The Anesthesia Care Team (ACT) is the predominant U.S. delivery model. In an ACT, one anesthesiologist medically directs one to four concurrent CRNA or AA cases. The anesthesiologist personally:

• Performs the pre-anesthetic examination and evaluation
• Prescribes the anesthesia plan
• Participates in critical phases including induction and emergence
• Ensures that procedures the anesthesiologist does not personally perform are performed by a qualified anesthetist
• Monitors the course of anesthesia administration at frequent intervals
• Remains physically present and available for immediate response to emergencies
• Provides indicated post-anesthesia care

When all seven TEFRA conditions are met, the ACT bills 50/50 (QK or QY by the anesthesiologist, QX by the CRNA). Total reimbursement equals 100 percent of the unit-based payment.

Alternative Models

Anesthesiologist personally performed: An anesthesiologist provides all anesthesia care personally without a CRNA. Anesthesiologist bills AA at 100 percent. Common in solo private practice and in cardiac, neurosurgical, and pediatric subspecialty cases at major academic centers.

CRNA-only practice (QZ): A CRNA provides anesthesia care without anesthesiologist medical direction. CRNA bills QZ at 100 percent. In opt-out states, no physician supervision is required. In non-opt-out states like Georgia, the CRNA must work under operating-practitioner or anesthesiologist supervision per 42 CFR 482.52(a)(4), but the modifier remains QZ as long as no anesthesiologist medically directs the case.

Anesthesiologist's Assistant practice: An AA provides anesthesia care under anesthesiologist supervision. AA services are billed under the supervising anesthesiologist's NPI with QK or QY modifier (treated like a CRNA case for billing). AAs always require anesthesiologist supervision under state and federal law (unlike CRNAs, who may practice without anesthesiologist supervision in opt-out states or under operating-surgeon supervision in non-opt-out states).

Georgia Provider Landscape

Major Hospital-Based Anesthesia Groups

Emory Healthcare Anesthesiology Department serves all Emory hospitals (Emory University Hospital, Emory Saint Joseph's, Emory Decatur, Emory Johns Creek, Emory University Hospital Midtown, Emory Eastside) and operates one of the largest academic anesthesiology programs in the Southeast. Emory's Anesthesia and Perioperative Medicine residency trains 16 to 18 residents per year and operates research programs in regional anesthesia, cardiac anesthesia, neuroanesthesia, obstetric anesthesia, and pain medicine. Emory also operates one of the few U.S. Anesthesiologist's Assistant training programs.

Piedmont Healthcare Anesthesiology serves Piedmont Atlanta, Piedmont Fayette, Piedmont Henry, Piedmont Newnan, Piedmont Mountainside, Piedmont Athens Regional, Piedmont Columbus, Piedmont Macon, Piedmont Walton, and the smaller Piedmont community hospitals. Piedmont employs a mix of anesthesiologists and CRNAs in an anesthesia care team model at most sites.

Wellstar Anesthesiology serves Wellstar Kennestone, Wellstar North Fulton, Wellstar Cobb, Wellstar Douglas, Wellstar Paulding, Wellstar Spalding Regional, Wellstar West Georgia, and Wellstar Sylvan Grove. Wellstar's anesthesia program also covers Wellstar MCG (Augusta) following the Wellstar-MCG affiliation.

Northeast Georgia Health System Anesthesiology serves NGMC Gainesville, NGMC Braselton, NGMC Barrow, and NGMC Lumpkin in the rapidly growing North Georgia region.

Memorial Health Anesthesiology (HCA Healthcare) serves Memorial Health University Medical Center in Savannah, the only Level I Trauma Center in southeast Georgia.

AU Health / Wellstar MCG Anesthesiology serves AU Medical Center (now Wellstar MCG Health) in Augusta, the academic medical center for the Medical College of Georgia.

Atrium Health Navicent Anesthesiology serves The Medical Center, Navicent Health in Macon.

Phoebe Putney Health System Anesthesiology serves Phoebe Putney Memorial Hospital in Albany and the Phoebe community hospitals across southwest Georgia.

Grady Anesthesiology serves Grady Memorial Hospital in downtown Atlanta, the largest public hospital in the Southeast.

Tanner Health System Anesthesiology serves Tanner Medical Center Carrollton, Tanner Medical Center East Alabama, and the smaller Tanner community sites in west Georgia.

National Anesthesia Groups Operating in Georgia

• US Anesthesia Partners (USAP): multiple Georgia hospital and ASC contracts
• North American Partners in Anesthesia (NAPA): multiple Georgia hospital and ASC contracts
• NorthStar Anesthesia: multiple Georgia community hospital contracts
• Pediatrix Medical Group (formerly MEDNAX): subspecialty pediatric and obstetric anesthesia at major Georgia children's hospitals and obstetric programs

CRNA-Only Practice and Rural Critical Access Hospitals

Across rural Georgia, the Critical Access Hospital network (small rural hospitals with 25 or fewer beds and at least 35 miles from the nearest hospital) often relies on CRNA-led anesthesia. Examples include Memorial Hospital and Manor in Bainbridge, Crisp Regional Hospital in Cordele, Meadows Regional Medical Center in Vidalia, Effingham Health System, Jeff Davis Hospital, Stephens County Hospital, Habersham Medical Center, and others. Because Georgia has NOT opted out of the federal supervision requirement, these CRNAs work under the supervision of the operating surgeon or other operating practitioner, satisfying 42 CFR 482.52(a)(4).

Georgia Anesthesia Workforce

As of 2026, approximately 2,800 anesthesiologists and 2,400 CRNAs practice in Georgia. The geographic distribution is uneven:

• Metro Atlanta concentrates about 60 percent of anesthesiologists
• Savannah, Macon, Augusta, Columbus, and Albany serve as regional centers
• Rural and small-town hospitals rely heavily on CRNAs

Georgia is one of approximately 18 states that recognize the Anesthesiologist's Assistant profession. The AA workforce in Georgia is smaller than the CRNA workforce but growing, supported by Emory's AA training program.

Regulatory Boards

The Georgia Composite Medical Board regulates physician anesthesiologists and Anesthesiologist's Assistants in Georgia. Requirements include an unrestricted Georgia medical license, completion of an ACGME-accredited anesthesiology residency for anesthesiologists, and supervision agreements for AAs.

The Georgia Board of Nursing regulates CRNA practice in Georgia. Requirements include an unrestricted Georgia RN license and current CRNA certification from the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA).

Georgia Conversion Factor and Locality

The Medicare Anesthesia Pricer divides Georgia into two localities for conversion factor purposes:

The Atlanta locality covers the counties in the Atlanta MSA. Rest of Georgia covers all other counties, including Savannah, Macon, Augusta, Columbus, Albany, and all rural counties. The locality boundary is updated periodically by CMS.

Worked Examples

Example 1: Margaret, 78, Atlanta, Cataract Phacoemulsification Under MAC at Emory Eye Center

Margaret is enrolled in Original Medicare with a Medicare Supplement Plan G. She had already met her $278 Part B deductible earlier in the year for unrelated services. She undergoes outpatient phacoemulsification cataract extraction at Emory Eye Center in Atlanta. The procedure takes 30 minutes under Monitored Anesthesia Care (MAC) provided by an anesthesia care team: an Emory anesthesiologist medically directs the CRNA, meeting all seven TEFRA conditions.

Billing calculation:

• Anesthesia CPT 00142 (cataract): 4 base units
• Time units (30 minutes / 15): 2.0 units
• Total units: 6.0 units
• Atlanta locality conversion factor 2026: $22.45
• Medicare-approved amount: 6.0 × $22.45 = $134.70
• Anesthesiologist bills modifier QK at 50 percent: Medicare pays the anesthesiologist about $53.88 (80 percent of $67.35)
• CRNA bills modifier QX at 50 percent: Medicare pays the CRNA about $53.88
• Margaret's 20 percent coinsurance: $26.94 total, paid entirely by Plan G
• Margaret's out-of-pocket for anesthesia: $0

Example 2: Robert, 82, Savannah, Elective Right Total Knee Arthroplasty Under General Anesthesia at Memorial Health

Robert is enrolled in Original Medicare with no Medigap. He undergoes elective right total knee arthroplasty at Memorial Health University Medical Center in Savannah. The case lasts 105 minutes of anesthesia time. The anesthesia care team model applies: one anesthesiologist medically directs four concurrent operating rooms (the maximum allowed under QK), and Robert's case has a CRNA under medical direction.

Billing calculation:

• Anesthesia CPT 01402 (TKA): 7 base units
• Time units (105 / 15): 7.0 units
• Total units: 14.0 units
• Rest of Georgia (Savannah) conversion factor 2026: $21.95
• Medicare-approved amount: 14.0 × $21.95 = $307.30
• Anesthesiologist bills QK at 50 percent: $153.65
• CRNA bills QX at 50 percent: $153.65
• Robert's 20 percent coinsurance: $61.46
• Robert's out-of-pocket for anesthesia: $61.46 (he has no Medigap)

Robert is also responsible for the surgeon's fee, the facility (outpatient department) fee, and any radiology or laboratory charges from the same episode.

Example 3: Linda, 75, Macon, Screening Colonoscopy with MAC at Atrium Navicent Ambulatory Surgical Center

Linda undergoes a routine screening colonoscopy at an ambulatory surgical center affiliated with Atrium Health Navicent in Macon. The procedure is documented as a screening (not diagnostic) under the ACA preventive screening framework. A polyp is detected and removed during the procedure. Linda has Original Medicare with Plan N Medigap.

Billing calculation:

• Anesthesia CPT 00813 (colonoscopy with screening): 5 base units
• Time units (35 / 15): 2.33 units
• Total units: 7.33 units
• Rest of Georgia conversion factor 2026: $21.95
• Medicare-approved amount: 7.33 × $21.95 = $160.89
• Anesthesia care team: anesthesiologist bills QK at 50 percent ($80.45), CRNA bills QX at 50 percent ($80.44)
• Beneficiary cost-sharing waived under ACA Section 4104 for screening colonoscopy anesthesia (BBA 2018 Section 53113 phased reduction applies for screening that becomes diagnostic due to polypectomy)
• Linda's out-of-pocket for anesthesia: $0

Example 4: Charles, 80, Augusta, Emergency Open AAA Repair at AU Medical Center

Charles presents to the AU Medical Center (now Wellstar MCG Health) emergency department in Augusta with a ruptured abdominal aortic aneurysm. He is rushed to the operating room. The on-call anesthesiologist personally performs all anesthesia care (no CRNA is available during the emergency call window). The case lasts 5 hours 20 minutes (320 minutes anesthesia time). Charles has Original Medicare with Plan G.

Billing calculation:

• Anesthesia CPT 00770 (open AAA repair): 15 base units
• Time units (320 / 15): 21.33 units
• Total units: 36.33 units
• Rest of Georgia (Augusta) conversion factor 2026: $21.95
• Medicare-approved amount: 36.33 × $21.95 = $797.44
• Anesthesiologist bills modifier AA (personally performed) at 100 percent: $797.44
• Charles's 20 percent coinsurance: $159.49, covered entirely by Plan G
• Charles's out-of-pocket for anesthesia: $0

Charles is also responsible for the Part A inpatient deductible ($1,676 in 2026, covered by Plan G), the surgeon's fee, the facility charges, the ICU charges, and any post-discharge skilled nursing or home health.

Example 5: Patricia, 73, Columbus, Outpatient Cataract Surgery Under Plan N

Patricia has Medicare Supplement Plan N and undergoes outpatient cataract surgery at Piedmont Columbus Regional Healthcare. The anesthesia is MAC, 25 minutes, anesthesia care team.

Billing calculation:

• Anesthesia CPT 00142 (cataract): 4 base units
• Time units (25 / 15): 1.67 units
• Total units: 5.67 units
• Rest of Georgia conversion factor 2026: $21.95
• Medicare-approved amount: 5.67 × $21.95 = $124.46
• Anesthesia care team: anesthesiologist bills QK at 50 percent ($62.23), CRNA bills QX at 50 percent ($62.23)
• Patricia's 20 percent coinsurance: $24.89
• Plan N covers the 20 percent Part B coinsurance except for the $20 office-visit copay and the $50 ER copay; anesthesia is not an office visit or ER visit, so Plan N covers the coinsurance in full
• Patricia's out-of-pocket for anesthesia: $0

If Patricia had Plan G instead, her out-of-pocket would also be $0 (Plan G covers the full 20 percent coinsurance). Plan G also covers Part B excess charges (the 15 percent above Medicare-approved amount providers may charge if they do not accept assignment), but this rarely matters for anesthesia because nearly all anesthesiologists and CRNAs accept Medicare assignment.

Example 6: Henry, 85, Rural Bainbridge, Outpatient Hernia Repair CRNA-Only at Memorial Hospital and Manor

Henry lives in Bainbridge in rural southwest Georgia. He undergoes outpatient inguinal hernia repair at Memorial Hospital and Manor, a Critical Access Hospital affiliated with the SGMC Health system. The hospital does not employ an anesthesiologist on-site; a CRNA provides anesthesia under the supervision of the operating general surgeon. Because Georgia has NOT opted out of the federal CRNA supervision requirement, the CRNA must be supervised. The operating surgeon satisfies the federal supervision requirement at 42 CFR 482.52(a)(4) (operating practitioner supervision).

Billing calculation:

• Anesthesia CPT 00834 (inguinal hernia repair): 4 base units
• Time units (45 / 15): 3.0 units
• Total units: 7.0 units
• Rest of Georgia conversion factor 2026: $21.95
• Medicare-approved amount: 7.0 × $21.95 = $153.65
• CRNA bills modifier QZ (CRNA without medical direction) at 100 percent: $153.65
• Henry's 20 percent coinsurance: $30.73
• Henry has Plan G, which covers the 20 percent coinsurance in full
• Henry's out-of-pocket for anesthesia: $0

This example illustrates the distinction between Conditions of Participation supervision (the operating surgeon supervises the CRNA, satisfying 42 CFR 482.52(a)(4) in non-opt-out Georgia) and Part B medical direction billing (no anesthesiologist medically directs the case, so the modifier is QZ rather than QX). Operating-surgeon supervision is a federal hospital requirement; anesthesiologist medical direction is a Part B billing concept that requires the seven TEFRA conditions.

Common Mistakes and Pitfalls

1. Confusing Hospital Supervision with Anesthesiologist Medical Direction

"Supervision" under 42 CFR 482.52 is a hospital Conditions of Participation requirement: the CRNA must work under the operating practitioner or under an immediately available anesthesiologist. "Medical direction" under 42 CFR 415.110 is a Part B billing concept that requires the anesthesiologist to satisfy all seven TEFRA conditions. A CRNA can be supervised (by the surgeon) without being medically directed (by an anesthesiologist). In that case, the modifier is QZ, not QX.

2. Assuming Georgia Is an Opt-Out State

Georgia has NOT opted out of the federal CRNA physician supervision requirement. Some neighboring states (Kentucky) opted out years ago; others (Tennessee, Alabama, Florida, South Carolina, North Carolina) have not opted out. Verify the opt-out status of any state where you receive anesthesia services before assuming a CRNA can work without physician supervision.

3. Billing QZ When an Anesthesiologist Medically Directs

When an anesthesiologist medically directs a CRNA case under the TEFRA seven conditions, the correct modifiers are QK (for 2 to 4 concurrent cases) or QY (for 1 case) for the anesthesiologist, and QX for the CRNA. QZ is incorrect because QZ indicates the absence of anesthesiologist medical direction.

4. Billing the AA Incorrectly

Anesthesiologist's Assistants must be billed differently from CRNAs. AAs always require anesthesiologist supervision under state and federal law. AA services are billed under the supervising anesthesiologist's NPI with the QK or QY modifier (treated like a CRNA case for billing purposes).

5. Calculating Time Incorrectly

Anesthesia time starts when the anesthesia provider begins to prepare the patient for anesthesia in the OR or equivalent area, not when the patient arrives at the hospital and not when the surgeon makes the incision. Time ends when the patient is safely placed under postoperative supervision, not when the surgeon closes. Anesthesia time is typically 20 to 30 minutes longer than surgical time.

6. Confusing Time Units with Time Minutes

One time unit equals 15 minutes. A 90-minute case yields 6.0 time units, not 90 time units. A 47-minute case yields 3.13 time units (47 / 15, rounded to one decimal place).

7. Adding Physical Status Modifiers for Medicare Payment

Medicare does NOT pay additional units for P3, P4, or P5 modifiers. Commercial payers and some Medicare Advantage plans do pay additional units for higher acuity, so providers continue to document and bill the PS modifier even though Medicare ignores it for payment.

8. Misunderstanding Screening Colonoscopy Anesthesia Cost-Sharing

Cost-sharing for anesthesia furnished during a screening colonoscopy is waived under ACA Section 4104 and the BBA 2018 Section 53113 phased reduction, even if a polyp is detected and removed during the screening procedure. Beneficiaries do not owe coinsurance for the anesthesia portion of a screening colonoscopy under the standard preventive screening framework.

9. Failing to Bill Modifier AD When Supervising More Than Four Cases

If an anesthesiologist exceeds four concurrent cases (medical supervision rather than medical direction), the modifier becomes AD. Payment under AD is reduced dramatically to 3 base units plus 1 time unit per case, not 50 percent of the full unit-based payment.

10. Ignoring Assignment

Most anesthesiologists and CRNAs accept Medicare assignment, which means they agree to accept the Medicare-approved amount as payment in full (minus the beneficiary's deductible and coinsurance). If a provider does not accept assignment, the limiting charge applies (up to 15 percent above the Medicare-approved amount), and the beneficiary may owe the excess. Plan G covers Part B excess charges; Plan N does not.

11. Confusing Surgical CPT Codes with Anesthesia CPT Codes

Anesthesia CPT codes (00100 through 01999) are different from surgical CPT codes (10000 through 69999). Each anesthesia code maps to one or more surgical codes via the ASA Crosswalk, which is updated annually by the American Society of Anesthesiologists.

12. Believing MAC Is Always Cheaper Than General Anesthesia

Base units depend on the procedure, not on the anesthesia technique (Monitored Anesthesia Care vs general vs regional vs spinal vs epidural). The Medicare-approved amount is the same regardless of which technique is used. Whether the patient receives MAC, regional, or general anesthesia for a given procedure does not change the unit-based payment for that procedure.

13. Treating a Medicare Advantage Plan Like Original Medicare

Medicare Advantage plans may charge facility copays or specialist copays per surgical episode rather than the standard 20 percent Part B coinsurance. Some MA plans use a prior authorization process for elective surgeries that includes the anesthesia component. Review the plan's Summary of Benefits and Evidence of Coverage to understand anesthesia cost-sharing under your specific plan.

14. Overlooking the BBA 1997 Conversion Factor Methodology

The annual anesthesia conversion factor is published in the Medicare Physician Fee Schedule Final Rule each November. The factor is updated annually to reflect changes in the Medicare Economic Index, geographic adjustments, and statutory updates. Using last year's conversion factor when calculating expected anesthesia charges will produce incorrect estimates.

COPD, Comorbidities, and Anesthesia Risk in Older Adults

Older Georgia Medicare beneficiaries frequently have one or more chronic conditions that affect anesthesia risk: cardiovascular disease, COPD, diabetes, kidney disease, dementia, and frailty. The ASA Physical Status classification (P1 through P5) reflects this acuity. Although Medicare does not pay additional units for PS modifiers, the anesthesia provider still classifies the patient and may adjust the anesthesia plan accordingly.

Preoperative consultation with an anesthesiologist is common for high-risk patients (P3 or higher), and these consultations are typically billed as Evaluation and Management services under the standard Physician Fee Schedule (not under the anesthesia unit-based methodology).

Brevy and How We Can Help

Brevy (brevy.com) is an eldercare advocacy organization that helps Georgia Medicare beneficiaries and their families understand Medicare coverage rules, including anesthesia services. We can help you read your anesthesia explanation of benefits, distinguish surgeon fees from anesthesia fees from facility fees, evaluate whether your anesthesia bill was calculated correctly under the unit-based methodology, and decide whether to appeal a denied anesthesia claim. We do not provide medical care; we provide information and advocacy.

::: accordion Q1: What is the difference between an anesthesiologist and a CRNA?

An anesthesiologist is a physician (MD or DO) who has completed medical school, an internship, and a four-year anesthesiology residency. Anesthesiologists are eligible to bill Medicare under Section 1861(s)(1) as physicians. A Certified Registered Nurse Anesthetist (CRNA) is an advanced practice registered nurse who has completed a graduate-level nurse anesthesia program (typically a Doctor of Nursing Practice or Doctor of Nurse Anesthesia Practice degree as of 2025), passed the National Board of Certification and Recertification for Nurse Anesthetists examination, and maintained an unrestricted state RN license. CRNAs are eligible to bill Medicare under Section 1861(s)(11) and Section 1861(bb), added by OBRA 1986 Section 9320.

Q2: What is an Anesthesiologist's Assistant?

An Anesthesiologist's Assistant (AA) is a master's-level clinician trained specifically in anesthesia. AAs graduate from an accredited AA program (Emory University operates one of the few U.S. programs), pass the National Commission on Certification of Anesthesiologist Assistants examination, and work under anesthesiologist supervision. Unlike CRNAs, AAs always require anesthesiologist supervision under state and federal law. Approximately 18 states (including Georgia) authorize AA practice.

Q3: How is anesthesia paid under Medicare?

Anesthesia services are paid using a unit-based methodology under 42 CFR 414.46. Payment equals (base units plus time units plus modifying units) multiplied by the locality-adjusted anesthesia conversion factor, multiplied by the modifier percentage. Base units come from the ASA Relative Value Guide. Time units equal one unit per 15 minutes of anesthesia time. The conversion factor is set annually by CMS and adjusted geographically. The modifier percentage reflects who delivered the service.

Q4: What is the 2026 anesthesia conversion factor in Georgia?

For 2026, the Atlanta locality conversion factor is approximately $22.45 per unit, and the rest-of-Georgia conversion factor is approximately $21.95 per unit. The exact figures are published in the Medicare Physician Fee Schedule Final Rule each November.

Q5: What are the TEFRA seven conditions?

The TEFRA seven conditions at 42 CFR 415.110 must be satisfied by an anesthesiologist for the anesthesiologist to bill medical direction modifiers (QK for 2 to 4 concurrent cases, QY for 1 concurrent CRNA case). The conditions are: (1) pre-anesthetic examination and evaluation, (2) prescribing the anesthesia plan, (3) personally participating in the most demanding procedures including induction and emergence, (4) ensuring procedures the anesthesiologist does not perform are performed by a qualified anesthetist, (5) monitoring the course of anesthesia at frequent intervals, (6) remaining physically present and available for immediate emergency response, and (7) providing indicated post-anesthesia care.

Q6: What does it mean if Georgia has not opted out of CRNA supervision?

Georgia has not opted out of the federal CRNA physician supervision requirement at 42 CFR 482.52(a)(4). Therefore CRNAs practicing in Georgia Medicare-certified hospitals and ambulatory surgical centers must work under the supervision of the operating practitioner (typically the operating surgeon) or under an immediately available anesthesiologist. The supervising physician need not be an anesthesiologist; the operating surgeon, dentist, or podiatrist qualifies. Supervision under 42 CFR 482.52(a)(4) is a Conditions of Participation requirement, separate from the Part B medical direction concept under 42 CFR 415.110.

Q7: What are the anesthesia modifiers and what do they mean?

AA = anesthesia personally performed by an anesthesiologist (100 percent payment). AD = medical supervision of more than 4 concurrent cases (reduced payment). QK = anesthesiologist medical direction of 2, 3, or 4 concurrent cases (50 percent payment). QY = anesthesiologist medical direction of 1 CRNA case (50 percent payment). QX = CRNA service with medical direction by an anesthesiologist (50 percent payment). QZ = CRNA service without anesthesiologist medical direction (100 percent payment).

Q8: How is anesthesia time measured?

Anesthesia time starts when the anesthesia provider begins to prepare the patient for anesthesia care in the operating room or equivalent area, and ends when the patient is safely placed under postoperative supervision. Time is rounded to one decimal place and converted to time units at one unit per 15 minutes.

Q9: Are physical status modifiers paid by Medicare?

No. Medicare does not pay additional units for ASA Physical Status modifiers (P3, P4, P5). Commercial payers and some Medicare Advantage plans do pay additional units. Providers document and bill the PS modifier regardless because it is part of the standard anesthesia record.

Q10: Do I owe 20 percent coinsurance for anesthesia?

Yes, under Original Medicare, the standard 20 percent Part B coinsurance applies to anesthesia services after the annual Part B deductible ($278 in 2026) is met. Medicare Supplement Plans G and N typically cover the 20 percent coinsurance. Medicare Advantage plans may charge specialist copay or percentage coinsurance per surgical episode.

Q11: Do I owe coinsurance for anesthesia during a screening colonoscopy?

No. Anesthesia furnished during a screening colonoscopy is treated as part of the preventive screening benefit under ACA Section 4104 and the BBA 2018 Section 53113 phased reduction. Beneficiary coinsurance is waived or substantially reduced, even if a polyp is detected and removed.

Q12: What is the Anesthesia Care Team model?

The Anesthesia Care Team (ACT) model is the predominant U.S. delivery model. One anesthesiologist medically directs one to four concurrent CRNA or AA cases, meeting all seven TEFRA conditions for each case. The team bills 50/50 (QK or QY by the anesthesiologist, QX by the CRNA or AA). Total reimbursement equals 100 percent of the unit-based payment.

Q13: Can a CRNA practice without anesthesiologist supervision in Georgia?

A CRNA may practice without anesthesiologist medical direction (and bill modifier QZ at 100 percent) in Georgia. However, because Georgia has not opted out of the federal supervision requirement, the CRNA must still be supervised by the operating practitioner or by an immediately available anesthesiologist under 42 CFR 482.52(a)(4). The operating surgeon typically satisfies this requirement in non-opt-out states.

Q14: What states have opted out of CRNA supervision?

As of 2026, 17 states have opted out: Iowa (2001), Nebraska (2002), Idaho (2002), Minnesota (2002), New Hampshire (2002), New Mexico (2002), Kansas (2003), North Dakota (2003), Washington (2003), Alaska (2003), Oregon (2003), South Dakota (2005), Wisconsin (2005), Montana (2005), Colorado (2010, CAH and rural only), California (2009), and Kentucky (2012). Other states, including Georgia, Tennessee, Alabama, Florida, the Carolinas, Virginia, and most of the South, have not opted out.

Q15: How are AA services billed?

Anesthesiologist's Assistant services are billed under the supervising anesthesiologist's NPI with modifier QK (for 2 to 4 concurrent cases) or QY (for 1 case). AAs always require anesthesiologist supervision and cannot bill QZ. The supervising anesthesiologist must meet the TEFRA seven conditions just as for a CRNA medical direction arrangement.

Q16: What is the ASA Relative Value Guide?

The ASA Relative Value Guide (RVG) is published annually by the American Society of Anesthesiologists. It lists base units for every anesthesia CPT code, mapped via the ASA Crosswalk to surgical CPT codes. CMS adopts the ASA RVG base units for Medicare payment under 42 CFR 414.46.

Q17: What is the BBA 1997 Section 4511 conversion factor methodology?

Section 4511 of the Balanced Budget Act of 1997 standardized the methodology for setting the anesthesia conversion factor. It tied annual updates to the Medicare Economic Index and aligned the geographic adjustment methodology with the broader Physician Fee Schedule Geographic Practice Cost Index. Before BBA 1997, anesthesia conversion factor updates were ad hoc.

Q18: What is the OBRA 1986 Section 9320 establishment of CRNA benefit?

Public Law 99-509 Section 9320, signed October 21, 1986, added Section 1861(s)(11) and Section 1861(bb) to the Social Security Act, establishing CRNA services as a separately reimbursable Medicare benefit effective January 1, 1989. Before this change, CRNA services were bundled into hospital DRG payments and were not separately reimbursable.

Q19: Does Original Medicare cover anesthesia for elective surgery?

Yes, when the underlying surgical service is covered by Medicare. Anesthesia for elective and non-elective procedures alike is covered under Section 1861(s)(1) (anesthesiologist) and Section 1861(s)(11) (CRNA). The 20 percent Part B coinsurance applies after the annual deductible. Cosmetic procedures and other non-covered services do not generate covered anesthesia services.

Q20: Does Medicare Advantage cover anesthesia?

Yes. Medicare Advantage plans must cover the same anesthesia services as Original Medicare under the Medicare Advantage parity rule. However, MA plans may charge facility copays or specialist copays per surgical episode rather than 20 percent coinsurance. Review the Summary of Benefits and Evidence of Coverage for your specific plan to understand cost-sharing.

Q21: How does Plan G compare with Plan N for anesthesia?

Plan G covers the full 20 percent Part B coinsurance for anesthesia services and also covers Part B excess charges (the 15 percent above Medicare-approved amount providers may charge if they do not accept assignment). Plan N covers the 20 percent coinsurance except for the $20 office-visit copay and the $50 ER copay, but does not cover Part B excess charges. For anesthesia services, Plan N and Plan G are functionally equivalent because anesthesia is not an office visit or ER visit, and almost all anesthesia providers accept assignment.

Q22: What is the Medicare Anesthesia Pricer?

The CMS Anesthesia Pricer is an annual file published by CMS listing the locality-specific anesthesia conversion factor for every Medicare Administrative Contractor jurisdiction. For Georgia in 2026, two localities exist: Atlanta (approximately $22.45 per unit) and Rest of Georgia (approximately $21.95 per unit). The Pricer is updated each November as part of the Medicare Physician Fee Schedule Final Rule.

Q23: What if I am charged more than the Medicare-approved amount?

If your anesthesia provider does not accept Medicare assignment, the limiting charge applies: up to 115 percent of the Medicare-approved amount (the 15 percent above is called Part B excess charges). Plan G covers Part B excess charges; Plan N does not. Almost all anesthesiologists and CRNAs in Georgia accept Medicare assignment, so this scenario is rare. Ask your anesthesia provider whether they accept assignment before any elective procedure.

Q24: Can I appeal an anesthesia claim denial?

Yes. Under Original Medicare, you have five levels of appeal: (1) redetermination by the Medicare Administrative Contractor (Palmetto GBA Jurisdiction J in Georgia), (2) reconsideration by a Qualified Independent Contractor, (3) Administrative Law Judge hearing, (4) Medicare Appeals Council review, and (5) federal district court review. Each level has specific deadlines and dollar thresholds. Medicare Advantage and Part D have similar five-level appeals frameworks. The Medicare Rights Center, Center for Medicare Advocacy, GeorgiaCares SHIP, Atlanta Legal Aid, and Georgia Legal Services Program offer free assistance.

Q25: How can Brevy help me with anesthesia billing questions?

Brevy (brevy.com) is an eldercare advocacy organization that helps Georgia Medicare beneficiaries understand Medicare coverage rules. We can help you read your anesthesia explanation of benefits, distinguish anesthesia fees from surgeon fees and facility fees, verify the unit-based billing calculation, identify whether you owe coinsurance, and decide whether to appeal a denied anesthesia claim. We can also connect you with GeorgiaCares (Georgia's SHIP program) and other free counseling resources. :::

Standard Disclaimers

This article is for general informational purposes only and does not constitute legal, medical, financial, or insurance advice. Medicare rules, payment rates, conversion factors, and state opt-out status change periodically. Verify all information with the relevant Medicare Administrative Contractor, the Centers for Medicare and Medicaid Services, your provider, and your Medicare Supplement or Medicare Advantage plan before making decisions. Brevy (brevy.com) provides advocacy and information services; we do not provide medical care or legal representation, and the content of this article does not establish any provider-patient or attorney-client relationship.

::: cta Contact Resources for Georgia Medicare Anesthesia Services

1. Medicare : 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048, medicare.gov
2. Palmetto GBA Jurisdiction J (Georgia Medicare Administrative Contractor) : 1-877-567-9230
3. Kepro QIO (Beneficiary and Family-Centered Care Quality Improvement Organization) : 1-844-455-8708
4. GeorgiaCares SHIP (Georgia's State Health Insurance Assistance Program) : 1-866-552-4464
5. Georgia DCH Medicaid Member Services : 1-866-211-0950
6. American Society of Anesthesiologists : 1-847-825-5586, asahq.org
7. American Association of Nurse Anesthesiology : 1-847-692-7050, aana.com
8. Georgia Society of Anesthesiologists : gsahq.org
9. Georgia Association of Nurse Anesthetists : gana-online.org
10. Georgia Composite Medical Board : medicalboard.georgia.gov
11. Georgia Board of Nursing : sos.ga.gov/georgia-board-nursing
12. Social Security Administration : 1-800-772-1213, TTY 1-800-325-0778, ssa.gov
13. HHS Office for Civil Rights : 1-800-368-1019, TTY 1-800-537-7697
14. HHS Office of Inspector General Hotline : 1-800-447-8477 (1-800-HHS-TIPS)
15. Medicare Rights Center : 1-800-333-4114, medicarerights.org
16. Center for Medicare Advocacy : 1-860-456-7790, medicareadvocacy.org
17. Atlanta Legal Aid Society : 404-377-0701, atlantalegalaid.org
18. Georgia Legal Services Program : 1-800-498-9469, glsp.org
19. Eldercare Locator : 1-800-677-1116
20. 211 Georgia (United Way of Greater Atlanta) : dial 2-1-1 :::