CMS recently published the 2011 Medicare unadjusted anesthesia conversion factor (CF). The unadjusted CF is $21.0515. Medicare determines anesthesia payment amounts via a “Base + Time” methodology where the base unit value assigned to the reported anesthesia code is added to the time units. For Medicare, report actual time on the claim and CMS will calculate the number of units out to one decimal place using a 15 minute unit. Geographic adjustments are made to the conversion factor – not to the base units.
This new unadjusted CF of $21.0515 is down from $21.57 in 2010. The decrease would have been greater if we were not currently in the second of a four year phase in of the 4% gains anesthesiology received as a result of the physician practice information survey. The unadjusted conversion factor would have been $15.81 had the Medicare Sustainable Growth Rate (SGR) fix not passed Congress in December of 2010.
Links:
2011 locale specific conversion factors
For unadjusted conversion factor: http://www.cms.gov/PhysicianFeeSched/downloads/AnesthesiaSharesCY2011.pdf