Clone of TAC - Rule 355.8221 - Reimbursement Methodology

This is a clone of the Texas Administrative Code (TAC) for educational purposes. It is not the official version and should not be used for legal purposes. Site created Wed, 21 May 2025 21:16:36 GMT

(a) Effective for services delivered on and after November 1, 2017, covered anesthesia services provided by a certified registered nurse anesthetist (CRNA) or an anesthesiologist assistant (AA) under the supervision of an anesthesiologist are reimbursed the lesser of the CRNA's or AA's billed charges or 50 percent of the calculated payment for a supervised anesthesia service. For example, if the calculated payment for a supervised anesthesia service is $100, the payment to the CRNA or AA would be $50.(b) Effective for services delivered on and after November 1, 2017, covered anesthesia services provided by a CRNA under the supervision of a physician, other than an anesthesiologist, are reimbursed at 92 percent of the calculated payment for an anesthesia service.

Source Note: The provisions of this §355.8221 adopted to be effective September 1, 1991, 15 TexReg 7618; amended to be effective May 1, 1993, 18 TexReg 2307; transferred effective September 1, 1993, as published in the Texas Register September 7, 1993, 18 TexReg 5978; duplicated effective September 1, 1997, as published in the Texas Register December 11, 1998, 23 TexReg 12660; amended to be effective July 1, 2006, 31 TexReg 5073; amended to be effective October 30, 2017, 42 TexReg 6000.