| "If I place an epidural in Medicaid pt, I get paid something like $36 for the placement, and I don't get a penny for watching this pt for next 18 hours." Wuh? I'm not a physician. But I do work for an ambulance service. And my day job has involved working with insurance reimbursement algorithms for Hospital and Insurance Administrators. But "$36 for epidural and not a penny for the next 18 hours?" You might want to look into that. Medicaid allows a Maximum Fee of $1.16/minute for an anesthesiologist's time. "Essentially, hospitals will be reimbursed at $669.90 for the epidural procedure performed in the hospital setting; whereas, in office setting, after removing the portion designated for the physician professional fee, office practice expense will be reimbursed at $30.28 to $34.36 a whopping 2,315% to 2,668% with SGR cut and 1931% to 2312% without SGR cut more in the hospital setting." Yes, epidurals are cut - but under what circumstances are you monitoring a patient bedside for 18 hours in a non-hospital setting? And for every one of these examples, there's a flip-side: Wisdom teeth under general anesthesia. "Hi, I'm Mr X and I'll be your anesthesiologist today. How you doing? Now, to confirm, no allergies, right? And it says you weigh 180lb? Great, see you in theater!" Bill: "Pre-operative anesthesiologist consultation: $662" For about 90 seconds. Now, I know the principles of anesthesia, though I'd never claim my knowledge was within orders of magnitude of that of a specialist, but I routinely perform RSI for ET intubation, and I know all about "the charge isn't for the time, it's the knowledge", but nonetheless. |