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Anesthesia Services Reimbursement Policy Change Effective April 1, 2024

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) updated their reimbursement policy for Anesthesia Services, Professional and Facility, effective April 1, 2024. 

Blue Cross NC will allow only three base units per procedure with the appropriate usage of Modifier AD. One additional base unit may be recognized on appeal if the physician documents their presence at induction.

Please review the February 1, 2024 reimbursement policy notification that was communicated previously for commercial plans for further information. 

This communication applies to State Health Plan (SHP), Administrative Services Only (ASO), Federal Employee Program (FEP), Fully Insured, and IPP Host. It does not apply to Medicare Advantage including Experience Health or IPP Home claims.