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The Nurse Anesthetist and Anesthesiologist Assistant Services Handbook includes information for certified registered nurse anesthetists (CRNAs) and anesthesiologist assistants (AAs) about covered services, reimbursement methodology, and billing.
Anesthesiologists should refer to the Physician Services Handbook, Anesthesia section, which includes information about covered services, reimbursement methodology, and billing.
For further information, go to Wisconsin Medicaid’s Web site, dhs.wisconsin.gov/medicaid/, which contains publications that may be downloaded, including Wisconsin Medicaid and BadgerCare handbooks and Updates.
What are Medicaid-Covered Nurse Anesthetist and Anesthesiologist Assistant Services?
Services provided by CRNAs and AAs include those anesthesia services prescribed by a physician that are within the scope of practice permitted CRNAs and AAs by their professional standards of practice. Refer to Appendix 1 of this handbook for a list of procedure codes covered by Wisconsin Medicaid for CRNAs and AAs.
Wisconsin Medicaid reimburses only those services that are medically necessary, appropriate, and, to the extent that alternative services are available, the most cost-effective. (Refer to the Glossary for Wisconsin Medicaid’s definition of medically necessary services.)
Refer to HFS 107.03, Wis. Admin. Code, and to HFS 107.06(5), Wis. Admin. Code, for services not covered by Wisconsin Medicaid.
Appendix 8 of this handbook is a partial list of noncovered services. Wisconsin Medicaid does not reimburse for anesthesia services provided with a noncovered service.
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