Commonwealth of Massachusetts
Executive Office of Health and Human Services
Office of Medicaid
www.mass.gov/masshealth
	MassHealth
	Physician Bulletin 91
	July 2011




	TO:	Physicians Participating in MassHealth

	FROM:	Terence G. Dougherty, Medicaid Director

	RE:	Anesthesia Services and 5010 Requirements


Background	The Centers for Medicare & Medicaid Services (CMS) has mandated that,
effective January 1, 2012, the standards for electronic health care 
transactions must change from version 4010/4010A1 to version 5010. 
MassHealth is actively working toward this January 1, 2012, 
implementation date. (See MassHealth All Provider Bulletin 210.) 

In addition to other 5010 changes, this mandate requires that anesthesia 
services, billed with service codes that do not have a specific time period 
defined in the description of the code, must be reported using minutes. 
This information was previously reported as 15-minute units under the 
4010 version of the transactions. However, 5010 mandates that reporting 
units for these anesthesia services be reported in one minute units.
	

System Requirements 	Anesthesia providers should confirm that their systems have the ability to 
provide only minutes for anesthesia time-based units, for service codes 
that do not have a time period in the description. If their systems do not 
have the capability to report only minutes for those service codes, they 
must update their systems immediately in order to support these 
mandated changes by January 1, 2012. Providers who use a software 
vendor or billing intermediary should confer with their vendor to confirm 
that they have the ability to support this change.
	

Determining Payable		Payable anesthesia time starts when the anesthesiologist begins to
Anesthesia Time	prepare the patient for the induction of anesthesia in the operating room, 
or equivalent area. Payable anesthesia time ends when the patient may 
be safely placed under postoperative supervision.
	
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Reporting Time Units	A provider’s claim must report only payable time units/minutes. It must not
include base anesthesia units/minutes or units/minutes that exceed the 
criteria described above, in the number of units/minutes field on the claim. 
Time units are measured in minutes. One unit equals one minute.
	

Effective Date	This change is effective for dates of service on or after January 1, 2012.
	

Questions	If you have any questions about the information in this bulletin, please 
contact MassHealth Customer Service at 1-800-841-2900, e-mail your 
inquiry to providersupport@mahealth.net, or fax your inquiry to 
617-988-8974.
  


			MassHealth
			Physician Bulletin 91
			July 2011
			Page 2