Your anesthesiologist takes several factors into account when recommending the type of anesthesia. Some of those factors include the type of surgery or non-operative procedure being performed and your medical history. These types of anesthesia are not always clearly defined, and patients may progress from one level of sedation/anesthesia to a lighter or deeper level during the procedure. For this reason, the American Society of Anesthesiologists (ASA) considers anesthesia a continuum, from light sedation to general anesthesia.


“Anesthesia Care Team”
Most anesthetics administered in Pennsylvania are provided using an “Anesthesia Care Team” model, with the anesthesiologist serving as the “director” of the anesthesia care team. Prior to surgery the anesthesiologist evaluates the patients’ current state of health and is responsible for designing the anesthesia plan taking into account the patient’s condition and the nature of the surgery.



  • Breaking News! Highmark Delays Policy Change

    5/30/2014 5/30/14: Highmark announces that it is delaying implementation of changes in coverage for full anesthesia until the fall so officials can meet with medical specialty groups that expressed concern, including PSA. The changes were scheduled to take effect July 1.

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  • Executive Summary of Survey on Anesthesia Available

    5/27/2014 5/27/14: An Executive Summary of the PSA survey of 800 Pennsylvania voters, conducted April 26-30, 2014, provides more detail to support the survey's clear conclusion: Pennsylvania voters want a doctor in charge of administering anesthesia.

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  • Breaking News! Highmark Blue Shield Policy Change

    5/22/2014 5/22/14: A Highmark Blue Shield policy change, effective June 30, 2014, states that "monitored anesthesia care is not considered medically necessary for colonoscopies, bronchoscopes, or interventional pain procedures in patients at average risk related to use of anesthesia and sedation" (ASA PS 1 & 2 patients). If you haven't done so already, contact your billing service to determine whether, or to what extent, this affects your practice.

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  • Breaking News! Most Pennsylvanians Want a Doctor to Supervise Anesthesia

    5/12/2014 5/12/14: Nearly 90 percent of Pennsylvanians want a physician to administer anesthesia or respond to anesthesia emergencies during surgery, according to a PSA survey released today.

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The choice of anesthetic or sedation is made by a physician taking into account various factors, including but not limited to the procedure being performed and the general medical condition of the patient. General anesthesia may be administered by an anesthesiologist, a nurse anesthetist under the direct supervision of a physician, preferably an anesthesiologist, or in some states by an anesthesiologist’s assistant under the direct supervision of an anesthesiologist. 

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The Anesthesiologist’s Expanding Role
The Centers for Medicare and Medicaid Services (CMS) released a January 2011 update to their Interpretive Guidelines for the Anesthesia Services Condition of Participation for Hospitals. As a result anesthesiologists have assumed a leadership role in developing and implementing medical staff rules and regulations (bylaws) that define the qualifications and supervision requirements for many “categories of practitioners”, such as those providers performing “Moderate Sedation”, “Deep Sedation” or obstetrical “analgesia” services. 

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