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Billing workers' compensation for anesthesia

Workers' comp claims follow state fee schedules and need information most claims don't. Miss it and the claim stalls.

State fee schedules

Most states set their own workers' comp fee schedule, including the anesthesia conversion factor and rules on time and modifiers. Rates can be higher or lower than Medicare. Look up your state's schedule.

What you need on the claim

  • The workers' comp claim number
  • The employer and the insurer or administrator
  • The date of injury
  • Any authorization number for the surgery

Don't bill the patient

In most states, providers can't bill injured workers for covered care. Work the claim with the insurer instead.

Expect delays

Workers' comp claims often move more slowly. Track them separately so they don't get lost in your aging report.

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

Sources

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