Wiki Versed

[NESmith]

When a CRNA bills for Versed will Medicare or commerical insurances reimburse a CRNA for this? We are having a very heated disagreement over this.

 

[Cordray]

Per HPCS Level II, Versed has a "special coverage instruction" notation, and the details are found in Appendix A, 100-02 Chapter 15, B3-2049.

Also, coverage may vary from Commercial carriers to Medicare. Per HPCS, "The Medicare program provides limited benefits for outpatient drugs. The program covers drugs that are furnished "incident to" a physician's service provided that the drugs are not ususally self-administered by the patients who take them."

In short, coverage depends on the insurance carrier's policy--for the specific medication administered-- and the policy for services rendered by a CRNA.