OB Epidural Billing

The American Society of Anesthesiologists Relative Value Guide lists the following methods as examples to determine professional charges for billing labor anesthesia services:

• Base units plus time reporting in minutes (insertion through delivery) subject to a reasonable cap.
• Base units plus one unit per hour for neuraxial anesthesia service management plus direct patient contact time, commonly referred to as Face Time.
• Incremental time-based fees (e.g. 0<2 hrs, 2-6 hrs, >6 hrs)
• Single or flat fee

Since practices determine their own method for billing OB anesthesia services, NextGen® Enterprise PM can accommodate commonly used and known methods of billing OB anesthesia services. These include:

• Pain Management epidurals should not be counted against maximum concurrency.
• Billing for labor cases that changed from a planned vaginal delivery to an emergency C-section. This is the only time billing two anesthesia codes on a claim is permitted.
• Some payers recognize only time in attendance with the patient and others time in attendance plus reduced time for management. The system must be able to bill accordingly.
• Practices are permitted to bill for epidural anesthesia as follows:
  • 15 minutes per unit for the first hour
  • 60 minutes per unit for the remaining time
  • Minimum charge is $400.00