There is no cap for billing, but realize when an operation goes long it not only means we make less per hour, but there is also usually a good reason for that. Even if there isn’t a good reason, it’s not like we have control over how fast a surgeon operates.
Clearly not, because this is how Medicare operates.
Yeah, we've been over this: Medicare does not set arbitrary caps on the length of a procedure. They pay for anesthesia services from the time the patient goes under to the time the patient wakes up. In fact, it's the whole premise for why Medicare is meant to bring prices down!
In fact, it's not. Limiting care is pretty much the opposite of how Medicare operates and you can see this reflected in the claim denials. For-profit insurance companies deny claims at 2–3x the rate of Medicare because they are incentivized to deny care.From Medicare's policy manual:
https://www.cms.gov/files/document/chapter2cptcodes00000-019...
A unique characteristic of anesthesia coding is the reporting of time units.
Payment for anesthesia services increases with time. In addition to reporting
a base unit value for an anesthesia service, the anesthesia practitioner reports
anesthesia time. Anesthesia time is defined as the period during which an
anesthesia practitioner is present with the patient. It starts when the anesthesia
practitioner begins to prepare the patient for anesthesia services in the operating
room or an equivalent area and ends when the anesthesia practitioner is no longer
furnishing anesthesia services to the patient (i.e., when the patient may be placed
Now I made a good faith look through your comment history to see if you'd actually posted anything like that. Barring something I missed I can only assume you're working based on an incorrect assumption of how Medicare pays for the cost of anesthesia.There is a fixed component per procedure (base unit). This is based on the complexity of a procedure and roughly how long it's expected to take. That is why CMS would track how long a procedure is expected to take. There is a time based factor (time unit), and that is not limited in the way that BCBS was proposing.
Later
(The comment I replied to was edited extensively after I replied to it.)