Medicaid Providers Anesthesia Billing Reminder

Date: 11/12/25

This notice applies to providers who deliver anesthesia services - HFS Category of Service (COS 017) for Meridian Medicaid Plan (Meridian) and YouthCare members.

For all claims received on or after November 20, 2025, Meridian and YouthCare will begin validating anesthesia claims to ensure compliance with IAMHP billing guidelines.

The billing requirements

• The date of service billed must be the date the anesthesia service begins.
• The procedure code can be either the major surgical procedure code or the anesthesia CPT code, but anesthesia is only paid for one procedure code per surgical session. Effective October 1, 2025, providers must use the appropriate anesthesia code in the CPT code range of 00100 through 01999 to bill for anesthesia units. The major surgical procedure codes will no longer be accepted.
• The physical status modifier, (P1 – P6), must be the first modifier on the claim.
• Total time for all anesthesia services provided during the surgical session is to be reported in minutes in the days/units field.
• Use any of these taxonomy codes to bill for HFS COS 017:
  
  • 207L00000X – Anesthesiology
  • 207LA0401X – Anesthesiology, Addiction Med P
  • 207LC0200X – Anesthesiology, Critical Care
  • 207LP2900X – Anesthesiology, Pain Medicine
  • 207LP3000X – Anesthesiology (Pediatric Anesthesiology)
  • 367500000Х - Certified Registered Nurse Anesthetist

Claims received on and after November 20, 2025, that are billed with the surgical procedure code instead of the anesthesia procedure code will be denied with code EX1f - Anesthesia must be billed with ASA code in the range 00100-01999*

Claims received on and after November 20, 2025, with a missing physical status modifier (P1-P6) will be denied with EX2h - ANESTHESIA MODIFIER VERIFICATION IL MEDICAID**

*CARC 16/RARC N440
**CARC 16/RARC N823

Please note: When providing services in an office setting for purposes of pain management (not related to postoperative intractable pain), providers cannot bill using the following taxonomy codes:

• 207L00000X – Anesthesiology
• 207LA0401X – Anesthesiology, Addiction Med P
• 207LC0200X – Anesthesiology, Critical Care
• 207LP2900X – Anesthesiology, Pain Medicine

These taxonomies are to be used only in conjunction with appropriate anesthesia CPT codes (00100 through 01999). For services performed in an office setting, a physician taxonomy code associated with HFS COS 001-physician services must be used.

A taxonomy code look-up tool is available here.

Examples include:

• 208600000X – Surgery
• 208D00000X – General Practice Physician
• 207R00000X – Internal Medicine
• 208VP0000X – Pain Medicine Physician

For questions please contact Provider Services at 866-606-3700 or reach out to your Provider Engagement contact. For more information on billing requirements download the IAMHP Billing Guide (PDF).

* CARC 16/RARC N440
**CARC 16/RARC N823