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Medicare Releases Billing Data - Anesthesiologists Among Lowest Ranked Specialties for Allowed Amounts

Wednesday, April 09, 2014

Today, the Centers for Medicare & Medicaid Services (CMS) released data on services and procedures furnished to Medicare beneficiaries by physicians and other health care professionals for CY2012. A preliminary review by ASA reveals the following key findings:

• There are 32,641 physician anesthesiologists, 1,856 interventional pain physicians, 30,160 nurse anesthetists, and 881 anesthesiologist assistants with claims data.

• Ranked by Medicare allowed amounts, anesthesiology is among the lowest specialties; interventional pain management is ranked ninth.

• For both nurse anesthetists and physician anesthesiologists, Medicare payment as percent of charges was 15 percent (14.7 percent for anesthesiology, 15.3 percent for nurse anesthetists).

• The data include provider identification information and CPT/HCPCS; they do not include ASA physical status, CPT/HCPCS billing modifiers (to determine personally performed, medical direction, supervision, etc.), or time units. 

The new data set has information for over 880,000 distinct health care providers who collectively received $77 billion in Medicare payments in 2012, under the Medicare Part B Fee-For-Service program. The data are drawn from the Physician/Supplier Part B Claims File, also known as the Carrier File, which captures Medicare fee schedule claims that are submitted by physicians and non-physician providers.

ASA is currently undertaking additional review and analysis of the data including an assessment of whether it accurately portrays the unique billing aspects associated with anesthesia care.
The data can be downloaded at: 

ASA Chart of Specialties with the Highest Medicare-Allowed Amount per Individual Physician
CMS Fact Sheet
CMS News Release

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