Understanding Anaesthetic Accounts

Your safety and satisfaction are our prime concerns.

However, the Government and other third parties require that financial issues be addressed and that patients receive an estimate of anaesthetic fees, where practical.

There will be a separate fee from your Anaesthetist for the anaesthesia services provided to you.

An Anaesthetists fees differ from that of a Surgeon as they are based on the anatomical site of the procedure, degree of difficulty, your age, the duration (time), any special monitoring or interventions and if it is conducted on an emergency basis.

Anaesthesia fees are derived from a ‘points system’ - a procedure will attract a number of ‘points’, called units. These are based on factors such as complexity of the procedure, the duration, your age, your health status, medical conditions and other factors (such as the use of special monitoring lines, nerve blocks, blood transfusions, epidurals, spinals etc.).

Emergencies (unplanned) and after hours procedures also attract more units. The AMA (Australian Medical Association) currently recommends a value per unit of $86. Your Anaesthetist may charge a rate of between $45 and $60 per unit, and often less when patients have needed multiple procedures.

All accounts for Anaesthesia may include the following:

1. An Item number which relates to a Pre-anaesthesia review involving consultation with the patient and review of a patient’s medical record in order to plan and administer the most appropriate anaesthesia. The Medicare Schedule specifies 2 ‘units’ apply to this item number.

2. An Item number which relates to a Basic Unit Value which relates to the type of procedure being performed. The Medicare Schedule specifies how many ‘units’ apply to this item number.

3. An Item number which relates to a Time Unit Value which begins when the Anaesthetist starts preparing a patient for anaesthetic care in the operating room or equivalent area and ends when the Anaesthetist is no longer in personal attendance. The Medicare Schedule specifies how many ‘units’ apply to this item number.

4. An Item number which relates to a modifying unit that applies when significant factors such as the medical condition or age of a patient which can significantly influence the provision of anaesthesia.

Wherever possible your Anaesthetist will provide you with an estimate of your anaesthesia fees prior to your procedure. However if you don’t know about your costs, or have any enquiries relating to anaesthesia fees, you should talk with your Anaesthetist before your procedure.

You should be aware that Medicare and health fund rebates may not cover the entire cost of your anaesthesia. This difference between what is covered and the actual fee for the anaesthesia services is known as the ‘gap’ and will be your personal responsibility to pay. Whether there will be a gap and the size of the gap varies greatly depending on your health fund. It is also usual for the gap to be larger when the surgery is of long duration. For more information regarding your health fund and/or to compare health funds, you can refer to the Federal Government Website: www.privatehealth.gov.au

More information about anaesthesia and Anaesthetists can be found in the patients’ section on the ASA website: www.asa.org.au

Parts of the information provided in this leaflet is courtesy of the Australian Society of Anaesthetists (ASA).