If the proposed CF is too low, the practice may not give the contract any further consideration. If the CF is high, the anesthesiologists may be inclined to accept the contract without more ado. In every case, though, the contract may contain other provisions that will affect the bottom line. A managed care organization might alternatively reference the Medicare payment system. Most commonly, payers allow one time unit for each 15 minutes of anesthesia time.
Payers have different methods of handling smaller increments of time, however.
The last sentence of this definition has caused the greatest amount of trouble. Although some carriers will pay a full fee for labor epidurals, on the basis of four time units per hour, most impose some type of limit. Any anesthesia group providing obstetric anesthesia services must understand exactly how the third-party payer intends to pay for labor epidurals. ASA was able to have the error corrected with respect to epidurals, but the CCI continues to bar payment for nerve blocks performed in conjunction with a surgical procedure. Appropriately addressing this issue includes specifying the basis for payment.