CRNA Exemption - JE Part A

Effective January 1, 1989, anesthesia services provided by Certified Registered Nurse Anesthetists (CRNAs) must be billed to Medicare Part B using the CMS-1500 form. However, beginning with calendar year 2004, hospitals may elect an exemption from this requirement under 42 CFR 412.113, provided they meet the following criteria:

• The hospital performed 800 or fewer surgical procedures, and
• The CRNA worked no more than 2,080 hours at the facility, including both inpatient and outpatient procedures requiring anesthesia.

This exemption is an annual election and must be made on a calendar year basis.

Electing the CRNA Exemption

Each October, a letter and questionnaire are sent to all providers who have qualified for the CRNA exemption in at least one of the previous two calendar years. Providers wishing to elect the exemption must complete and return the questionnaire, including the section detailing the number of procedures and hours of service.

For your convenience, a Certified Registered Nurse Anesthetist (CRNA) Exemption Request Form is available on our Audit and Reimbursement Forms page.

In addition to the completed questionnaire, providers must submit annual agreements signed by each CRNA, affirming that they will not bill the Part B carrier for services rendered at the facility.

Submission Deadline

To ensure the exemption is effective for the upcoming calendar year, the completed questionnaire and signed CRNA agreements must be submitted by December 15 of each year.