Hawaii Administrative Rules
Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS
Chapter 23 - MOTOR VEHICLE INSURANCE LAW
Subchapter 17 - FEE SCHEDULE AND UTILIZATION GUIDELINES
Section 16-23-110 - Anesthesia services
Current through February, 2024
(a) A base unit is listed for all procedures in the medical fee schedule in accordance with section 16-23-115. This includes the base unit of all anesthesia services except the value of the actual time spent administering the anesthesia or in unusual detention with the patient.
(b) As allowed under Medicare, the anesthesia charges are equal to the sum of the base and time units for the service multiplied by a geographical adjusted anesthesia-specific conversion factor.
(c) The total value for anesthesia services includes pre- and post-operative visits, the administration of the anesthetic, and the administration of fluids and blood incident to the anesthesia or surgery.
(d) The time units are computed by dividing the total anesthesia time by fifteen minutes.
(e) Calculated values for anesthesia services shall be used when the anesthesia is administered by an appropriately licensed health care provider and a fee shall be paid only for the individual anesthetic service.
(f) If the general or regional anesthetic is administered by the attending health care provider, the value shall be fifty per cent of the calculated value.
(g) A separate charge may be made for necessary drugs and materials provided by the health care provider or anesthetist in accordance with section 16-23-114.
(h) When unusual detention with the claimant is essential for the safety and welfare of the claimant, the necessary time will be valued on the same basis as indicated for anesthesia time.
(i) No additional fee shall be allowed for local infiltration or digital block anesthesia administered by the operating physician.
(j) When either a hypothermia or a pump oxygenator, or both, are employed in conjunction with an anesthetic, the anesthetic "basic" value will be equal to that of procedure code 00560.
(k) Where anesthesia is administered for dental services, if the above rules are not applicable, a fee equal to that of the procedure code 00122 for inhalation anesthesia and equal to that of procedure code 00102 by an intravenous route will be allowed.
