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Advocating for You: ASA advocates for fair anesthesia payments

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Physician anesthesiologists intubate and monitor a patient in their care.

Why This Matters

Big insurance companies have used increasingly aggressive, profit-driven behaviors to harm frontline physicians and health care professionals. Insurance companies have developed, proposed, and implemented several workarounds to federal and state regulations, renegotiated anesthesia contracts midway through agreed upon terms, and have failed to appropriately pay for anesthesia services.

Anesthesiologists and their practices are often at a disadvantage when assessing the impact policy changes will have on their revenues and their ability to cover service lines. Many insurance companies have leveraged their stranglehold on state-level insurance markets to slash payments to front-line health care professionals, often without regard to patient or clinical needs. ASA is leading efforts protecting patient access to care, ensuring accountability among insurers, and fighting for appropriate anesthesia payments.

What You Should Know

Faced with some bad insurance behaviors? Here are the policies ASA is fighting:

  • Insurer-Imposed Facility Penalties: Anthem Blue Cross Blue Shield implemented a policy to reduce facility payments by 10% if any services are rendered by out-of-network providers. While the penalty is aimed at hospitals, it poses significant consequences for anesthesiology practices and introduces an unnecessary distraction for hospitals, anesthesiologists, and patients. 

  • Capping Anesthesia Time: Several Anthem plans wanted to upend common billing and coding practices by proposing to pay for only a portion of a patient’s anesthetic. The policy, now rescinded, would have denied anesthesia payments for patients who may require longer surgeries or have complications that result in anesthesia time longer than Anthem's arbitrary time limits. ASA remains vigilant against such insurance schemes to not pay for a patient’s full anesthesia care. 

  • Removing Payments for Physical Status (PS) Modifiers: Several insurance companies have reduced payments for anesthesiologists who care for sicker patients by removing Physical Status Modifiers from the equation. Short-sided decisions like this means anesthesia groups, hospitals, and patients will need to cover for the bad policy decisions of insurance companies. 

  • Halting Payments for Qualifying Circumstances: Insurance companies have also cut payments for anesthesiologists treating patients who require emergency care or are of certain ages (under 1-year-old or over 70 years of age) by removing payments for qualifying circumstances. Anesthesiologists are there for their patients during their most vulnerable times – fair compensation using long-established payment norms for the work of anesthesiologists is common sense.

  • Gaming the No Surprises Act: Insurers are using the No Surprises Act to hide from and delay payment for anesthesia services. Making timely payments to anesthesia groups who win the arbitration shouldn’t be up for debate. It’s time for insurance companies to live up to the basics of the NSA. Do you know the No Surprises Act like you should?

What ASA is Doing For You 

At the state level, ASA is aggressively challenging these misguided insurer policies nationwide. Since 2025, ASA and its state component societies have secured laws in seven states (CT, IL, MD, MO, OK, OR, UT) prohibiting arbitrary anesthesia time limits. Beginning in 2026, three states (IA, IN, LA) enacted protections against insurer penalties tied facilities working with out-of-network professionals, and Oklahoma protected payment for Physical Status (PS) modifiers with a new law. Through engagement with federal regulators, the Society strongly promotes transparent, patient-centered payment policies and advocates for appropriate compensation for anesthesia and pain medicine services.

See ASA's recent initiatives to combat insurance abuses at Washington Alerts.

What You Can Do Now

When unfair changes to payer policies are proposed, anesthesiologists and their groups need to quickly assess the impact such policies would have on revenue, service line coverage, and patient access to timely care. Contact advocacy@asahq.org if you or your group has been affected by bad behavior from the insurance companies. 

This page was last updated August 12, 2026.

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