Reimbursement policy update: Anesthesia Services

Effective November 15, 2026, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is updating its Anesthesia Services, Facility Billing Guidelines, and Services Bundled Into Inpatient/Outpatient Stays reimbursement policies.

Under this update, anesthesia services will be reimbursed only when submitted on a professional claim. Anesthesia services provided by anesthesiologists and certified registered nurse anesthetists (CRNAs) will not be eligible for reimbursement when submitted on a facility claim.

Anesthesia services should be submitted on a CMS-1500 professional claim form. Anesthesia-related services, supplies, and equipment are considered incidental to facility reimbursement and will no longer be eligible for separate reimbursement.

If you currently bill CRNA services on a facility claim form, please contact our Network Management department at 800-777-1643 to request a professional contract for CRNA services.

This change aligns with CMS guidance and industry reimbursement practices and helps reduce the potential for duplicate reimbursement when anesthesia services are submitted on both professional and facility claims. For additional information, please review the related Commercial policy notification. A supplemental update to the current Blue Book will be made to support this effort.

This policy applies to Commercial, Inter-Plan Program (IPP) Host, and Federal Employee Program (FEP). This does not apply to IPP Home. This is already applicable to Medicare Advantage.