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Getting paid

How CRNAs get paid by Medicare

The basics every CRNA billing Medicare should understand.

The payment

Medicare pays anesthesia using base units, time units and a conversion factor. See the formula explained.

Who gets what

If you work without medical direction, the claim uses QZ and you can be paid the full fee. If an anesthesiologist medically directs you, you bill with QX and Medicare generally splits the fee with the anesthesiologist.

Medicare pays 80 percent

Under Part B, Medicare usually pays 80 percent of the allowed amount after the deductible. The patient or their secondary insurance owes the rest.

You have to be enrolled

You and your group need Medicare enrollment, and you'll usually reassign your benefits to the group so payments go there. See reassignment explained.

This article is general information, not billing, legal or tax advice. Payer rules change; always check current guidance.

Sources

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