Anesthesia Services Rate Increases
The South Carolina Department of Health and Human Services (SCDHHS) is updating the payment methodology for anesthesia services. Effective for dates of service on or after Oct. 1, 2023, the anesthesia base rates for anesthesiologists will be set at 88% of the 2022 Medicare fee schedule. This updated payment methodology for anesthesia services will also apply to the calculations for certified registered nurse anesthetists (CRNAs) rates as indicated in the State Plan.
The chart below shows the new reimbursement rates.
| Procedure Code Range | Modifier | New Rate |
|---|---|---|
0100-01999 (Excludes 01967, 01968, 01996) | AA - administered by anesthesiologist | $18.32 |
0100-01999 (Excludes 01967, 01968, 01996) | QX -administered by CRNA under anesthesiologist supervision | $9.16 |
0100-01999 (Excludes 01967, 01968, 01996) | QZ - administered by CRNA without anesthesiologist supervision | $16.49 |
The updated rates will be published in the Anesthesia Fee Schedule available on SCDHHS’ website by Oct. 1, 2023.
South Carolina’s Healthy Connections Medicaid managed care organizations (MCOs) are responsible for the coverage and reimbursement of services described in this bulletin for members who are enrolled in an MCO.
Providers should direct questions related to this bulletin to the Provider Service Center (PSC). PSC representatives can be reached at (888) 289-0709 from 7:30 a.m.-5 p.m. Monday-Thursday and 8:30 a.m.-5 p.m. Friday. Providers can also submit an online inquiry at: http://www.scdhhs.gov/contact-us.
Thank you for your continued support of the South Carolina Healthy Connections Medicaid program.