MedicaidReimbursementHigh impact
Billing for Anesthesia Services for Dates of Service on or after 12/1/03
Maryland Medicaid·MD · Anesthesiology·Managed Care Organizations
Effective date
Dec 1, 2003
We identified it
Jun 20, 2026
Summary
Maryland Medicaid updated anesthesia billing methodology effective December 1, 2003, adding new CPT codes, changing the reimbursement formula, and establishing minimum payment amounts with specific modifier requirements.
Action Required
Immediately: Billing team must update anesthesia billing to use new formula: [Time Units (Minutes) + (Base Units x 15 Minutes)] x Procedure Fee x Modifier % = Payment. Report total anesthesia minutes in Block 24G of CMS-1500 except for procedures 01995 and 01996 which must be billed as 1 unit only. Update system to enforce minimum payments: $30 for modifiers AA and QZ, $15 for modifiers QK, QX, and QY. For neuraxial labor analgesia/anesthesia (01967), bill only time when provider is physically present with patient.