Who We Are We are Prime Medical Billing Solutions, LLC, a results-driven medical billing and revenue cycle partner headquartered in Atlanta, Georgia. Since about 2015, we have operated with the belief that true value lies in partnering, rather than merely contracting, with providers to ensure personalized attention and peak revenue performance. Founded by seasoned billing professionals with 20+ years of combined expert experience, our home office in Atlanta supports both individual practices and larger provider groups. Our team is passionate about maximizing reimbursements and simplifying the billing journey step by step. What Services We Offer We provide a comprehensive suite of services designed to optimize every phase of the revenue cycle: Claims processing & billing management, including electronic, UB‑04, and HCFA‑1500 formats Accounts receivable and collections, focusing on paid-to...
Anesthesia Medical Billing Services
Anesthesia is paid on base units, time units and modifiers, not on simple fee schedules. Specialist billers make sure every minute and every modifier is captured.
- Base + time + modifying units calculated for every case
- Medical direction and CRNA modifiers (AA, QK, QX, QZ) applied correctly
- Separate billing for nerve blocks, lines and pain procedures
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How anesthesia billing is different
Anesthesia claims are calculated with a unique formula: (base units + time units + modifying units) × conversion factor. Base units come from the anesthesia code for the procedure, time is reported in minutes from start to end of anesthesia care, and physical status modifiers and qualifying circumstances can add units.
Who performed the service matters just as much. Personally performed anesthesia, medical direction of CRNAs, medical supervision and CRNA-only services each use different modifiers and payment percentages. A wrong modifier can cut payment in half or trigger a compliance problem.
Anesthesia groups also bill separate procedures, peripheral nerve blocks for post-operative pain, arterial and central lines, and TEE, that follow their own bundling rules. A specialist billing team reconciles anesthesia records against surgical schedules so no case or add-on service is missed.
Common anesthesia billing challenges
Accurate anesthesia time
Time must be documented to the minute. Rounding or missing end times quietly reduces payment on every case.
Concurrency and medical direction
Directing multiple CRNAs changes modifiers and payment rules. Errors are a common audit finding.
Physical status and qualifying circumstances
P3–P5 modifiers and codes for extreme age or emergency can add units but are often missed.
Separate procedure bundling
Nerve blocks, lines and TEE are only separately billable under certain conditions.
Case reconciliation
Without matching anesthesia records to OR schedules, cases go unbilled, especially at multiple facilities.
Payer-specific conversion factors
Each payer pays a different conversion factor, so underpayments are hard to spot without contract tracking.
What a anesthesia billing partner should handle
- Anesthesia record review and time calculation
- ASA/CPT anesthesia code assignment
- Physical status and qualifying-circumstance coding
- Medical direction and CRNA modifier compliance
- Nerve block, line and TEE billing
- Daily case reconciliation with facility schedules
- Contract and conversion-factor underpayment tracking
- Denial management and appeals
- Provider productivity and concurrency reporting
- Credentialing for anesthesiologists and CRNAs
Key codes in anesthesia billing
| Code(s) | What it covers |
|---|---|
| 00100–01999 | Anesthesia procedure codes, each with an assigned base unit value. |
| AA / AD | Anesthesia personally performed by an anesthesiologist / supervision of more than four procedures. |
| QK / QY | Medical direction of two to four concurrent procedures / of one CRNA. |
| QX / QZ | CRNA service with medical direction / CRNA service without medical direction. |
| P1–P6 | Physical status modifiers describing patient health, which can add units. |
| 99100–99140 | Qualifying circumstances such as extreme age, hypothermia or emergency. |
| 64400–64530 | Peripheral nerve blocks, separately billable for post-operative pain when criteria are met. |
Code examples are for orientation only. Always code from the current CPT®, HCPCS and ICD-10-CM code sets and payer policies.
Medical direction compliance
Medicare requires the anesthesiologist to perform and document specific steps, pre-anesthetic exam, plan, induction and emergence participation, monitoring and availability, for medical-direction billing. Your billing partner should check this documentation before using QK or QY.
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How much does anesthesia billing cost?
Most billing companies charge a percentage of what they actually collect, so their incentive matches yours. Complex specialties sit at the higher end of the range because of prior authorizations, modifiers and appeal work.
Most common. You pay only on money collected.
Predictable for high-volume, low-complexity claims.
Dedicated billers working inside your systems.
Typical market ranges; actual quotes depend on claim volume, payer mix and scope. Compare quotes from several companies.
Anesthesia billing FAQs
Payment equals base units plus time units plus any modifying units, multiplied by the payer’s conversion factor. Time is usually counted in 15-minute units for Medicare.
They tell the payer who provided the anesthesia: personally performed by an anesthesiologist (AA), medical direction of concurrent cases (QK), CRNA with direction (QX) or CRNA without direction (QZ).
Peripheral nerve blocks for post-operative pain can often be billed separately when requested by the surgeon and documented, but not when they are the primary anesthetic.
Common causes are missing or rounded time, missed physical status modifiers, wrong medical-direction modifiers and payers applying the wrong conversion factor.
Yes. Experienced anesthesia billers handle physician-led, care-team and CRNA-only practices across hospitals, ASCs and office-based settings.
Typically 5% to 8% of collections, depending on case volume and the number of facilities served.
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