​The Medical Necessity of Anesthesiology Services American Society of Anesthesiologists' Position Statement

Developed By: Committee on Practice Management
Committee of Oversight: Committee on Economics
Last Amended: October 17, 2018 (original approval: October 16, 2013)

There is no circumstance when it is considered acceptable for a person to experience emotional or psychological duress or untreated pain amenable to safe intervention while under a physician’s care.

Anesthesiology is a discipline within the practice of medicine that involves the safeguarding and medical management of patients who are rendered unconscious and/or insensible to pain and emotional distress during surgical, obstetrical and other medical procedures.

The decision as to the medical necessity for anesthesiology services for a particular patient is a medical judgment that must consider multiple factors including, but not limited to patient preference, the patient’s underlying medical co-morbidities, the type of procedure, the potential interventions that may be needed to maintain hemodynamic and pulmonary stability, and the requirements of the physician performing the surgery/procedure. In addition, the medical necessity for anesthesiology services is independent of the amounts or types of medications that are given during the service. 

This decision of necessity for anesthesiology services applies to all medical procedures, including screening or therapeutic procedures. For some patients, the availability of anesthesia services to alleviate anxiety over the procedure may be the determining factor to proceed. 

The ASA does not support determinations of medical necessity for anesthesiology services made independently by organizations or health insurance plans.