Reimbursement and Regulations

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By Joseph W. Galassi, M.D.


In 2008, there was a move by several private insurance companies to limit or eliminate the reimbursement for anesthesia services for routine endoscopy. Due to significant lobbying efforts by the Pennsylvania Society Anesthesiologists (PSA) – as well as a number of other organizations and individual physicians – these potential changes have at the least been postponed.

To our knowledge, there is no current activity on this matter. The Pennsylvania Society Anesthesiologists will remain vigilant in monitoring potential changes in the future.

Non-Anesthesiologist Physician Supervision of CRNA Anesthesia Care

Any physician (M.D. or D.O.) may medically direct or supervise the provision of anesthesia by a Certified Registered Nurse Anesthetists (CRNA). Several other physician specialties routinely provide this care for their patients. This includes, but is not limited to, the following medical specialties:

  • Gastroenterology
  • Cardiology
  • Plastic surgery
  • Colorectal surgery

These physicians are held to the same standard of care as an anesthesiologist when they medically direct or supervise CRNAs. It is presumed that they are competent to provide appropriate medical decision making in regard to their patient’s anesthesia care. They may also bill for anesthesia services in addition to the charges for the surgery or procedure.


Physicians Protecting Patients