2023 Blue Cross and Blue Shield Service Benefit Plan - FEP Blue Focus
Section 5(b). Surgical and Anesthesia Services Provided by Physicians and Other Healthcare Professionals
Page 68
Section 5(b). Surgical and Anesthesia Services Provided by Physicians and Other Healthcare Professionals
Page 68
Benefit Description
Organ/Tissue Transplants (cont.)
You Pay
All charges
Organ/Tissue Transplants (cont.)
- Travel costs related to covered transplants performed at facilities other than Blue Distinction Centers for Transplants; travel costs incurred when prior approval has not been obtained; travel costs outside those allowed by IRS regulations, such as food-related expenses
You Pay
All charges
Benefit Description
Anesthesia
Anesthesia services consist of administration by injection or inhalation of a drug or other anesthetic agent (including acupuncture) to obtain muscular relaxation, loss of sensation, or loss of consciousness.
Anesthesia (including acupuncture) for covered medical or surgical services when requested by the attending physician and performed by:
Professional services provided in:
Notes:
You Pay
Preferred: 30% of the Plan allowance (deductible applies)
Non-preferred (Participating/Non-participating): You pay all charges
Anesthesia
Anesthesia services consist of administration by injection or inhalation of a drug or other anesthetic agent (including acupuncture) to obtain muscular relaxation, loss of sensation, or loss of consciousness.
Anesthesia (including acupuncture) for covered medical or surgical services when requested by the attending physician and performed by:
- A certified registered nurse anesthetist (CRNA), or
- A physician other than the physician (or the assistant) performing the covered medical or surgical procedure
Professional services provided in:
- Hospital (inpatient)
- Hospital outpatient department
- Skilled nursing facility
- Ambulatory surgical center
- Residential treatment center
- Office
Notes:
- Anesthesia acupuncture services do not accumulate toward the member’s annual maximum.
- See Section 5(c) for our payment levels for anesthesia services billed by a facility.
You Pay
Preferred: 30% of the Plan allowance (deductible applies)
Non-preferred (Participating/Non-participating): You pay all charges