Policy Matters  |   December 2015
Trends in Number of Medicare Anesthesia Claims by Facility Setting, 1994-2014
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Practice Management / Advocacy and Legislative Issues / Policy Matters
Policy Matters   |   December 2015
Trends in Number of Medicare Anesthesia Claims by Facility Setting, 1994-2014
ASA Monitor 12 2015, Vol.79, 10-11.
ASA Monitor 12 2015, Vol.79, 10-11.
The 20-year period between 1994 and 2014 saw increases in both the number of Medicare fee-for-service beneficiaries and in the volume of the health services they received that required anesthesia. We estimate that the number of Medicare fee-for-service beneficiaries increased approximately 10 percent during this period*1 1 -3  while the anesthesia claims count increased 136 percent. In this abbreviated “Policy Matters,” we show that the mix of facility settings where these services were provided also changed substantially.
Our analysis was based on the Medicare Physician Supplier Procedure Summary Master File, which provides counts of the number of claims submitted on behalf of Medicare’s fee-for-service beneficiaries. Claim counts can be summarized by Current Procedural Terminology (CPT®) codes, type of professional submitting the claim and place of service (i.e., facility setting such as inpatient hospital, outpatient hospital, ambulatory surgery center, office and others). We obtained counts of the number of claims submitted with an anesthesia CPT® code (00100 to 01999, excluding 01996: “daily hospital management of epidural or subarachnoid continuous drug administration”). We excluded counts of claims recorded as being submitted by entities rather than persons and excluded claims attributed to health care professionals that typically would not submit an anesthesia claim (e.g., audiologists, chiropractors, social workers and physical therapists). These exclusions represented less than 0.3 percent of anesthesia-related service counts in 2014. We also adjusted counts to avoid double counting of anesthetics resulting from multiple billings for the same case that occurs in the anesthesia care team model (i.e., anesthesiologists providing and non-anesthesiologists receiving medical direction or supervision).
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