ASA Urges Optum to Recognize Separate Payment for Anesthesia Care for Electroconvulsive Therapy

The American Society of Anesthesiologists (ASA) has issued a strong call for Optum to reconsider and reverse its reimbursement policy that bundles payment for anesthesia services with Electroconvulsive Therapy (ECT). In a formal letter to Optum, ASA expressed concern that the policy is inconsistent with established billing standards and may undermine patient safety.

ECT is a specialized medical procedure performed under general anesthesia with neuromuscular blockade, during which a controlled electrical stimulus induces a therapeutic seizure. An anesthesiologist is an essential member of the care team, responsible for ensuring safe administration of anesthesia and maintaining patient stability throughout the procedure.

Under Optum’s current policy, anesthesia services billed using CPT® code 00104 (Anesthesia for Electroconvulsive Therapy) are considered part of a bundled payment and are not reimbursed separately when submitted in conjunction with ECT services. ASA emphasized that this policy fails to recognize the distinct, medically necessary role of anesthesiologists in the delivery of ECT.

ASA further noted that anesthesia services are routinely and appropriately paid as separate services from procedural care across medical practice. Given the clinical complexity and risks associated with ECT, ASA asserts that these services should not be treated differently.

ASA is urging Optum to take immediate corrective action by rescinding the policy and aligning its reimbursement practices with CMS guidance and CPT coding standards. This includes recognizing anesthesia services as separate, medically necessary, and independently billable.