Anesthesia Payment Policy Correction
Posted on October 18, 2016
Please read the following update related to various Health New England programs and changes that may have an impact on your patients and/or your practice.
Correction to Anesthesia Payment Policy specific to the AD modifier:
On an annual basis, Health New England conducts various auditing and monitoring activities to fulfill our responsibility to our provider partners by identifying any potential gaps between language in our payment policies and configuration to support the payment policy language.
During a recent review, we identified an error in our Anesthesia Payment Policy specific to the AD modifier. Our current policy outlines an allowable amount of 100% of the anesthesia rate when the AD modifier is appended. However, the correct allowable amount is 50% of the anesthesia rate when the AD modifier is appended.
Effective January 1, 2017, our Anesthesia Payment Policy will be updated to reflect the correct allowable amount. Health New England will not retract incorrect payment specific to this error. The updated payment policy can be found at healthnewengland.org/providers/resources.
