To reduce rejected claims and ensure compliance, The Medical Services Plan (MSP) reissued a broadcast message for 2026 reminding all practitioners billing for Diagnostic Anaesthesia and Therapeutic Anaesthesia services to adhere to evidence-based care principles and the MSP Payment Schedule for Physicians.
MSP recommends that physicians billing for these codes:
- Review billing practices for anaesthesia services
- Correct any discrepancies in documentation or coding
- Remind all billing staff and clinical teams involved in anaesthesia services of correct billing practices
Key Anaesthesia Billing Principles
- Nerve Root or Facet Blocks: (Fee Items 01140,01141,01142,01143,01144 & 01145)
Must be performed under medical imaging guidance (ultrasound, fluoroscopy or CT) with image capture. MSP may request proof of image capture to ensure compliance with this requirement. - Joint injection, aspiration or arthrogram, under radiological guidance (Fee Item 00811)
Payable only if performed under medical image guidance, otherwise will pay as 00757 Joint aspiration - procedural fee. - Repeat injections of corticosteroids
Multiple sources in medical literature support limiting corticosteroid injections to a maximum of three to four per anatomic site per year, with intervals of at least three months between injections. Claims must reflect the primary purpose of the service provided and repeat injections within 3 months may require additional notes to explain rationale. - Repeat injections of local anaesthetics
Current clinical guidelines, including the 2025 BMJ guideline, issue strong recommendations against the repeated use of local anesthetic injections for chronic spine pain, citing a lack of evidence for long-term benefit and potential for harm. Local anesthetic blocks are primarily recommended for diagnostic purposes or as part of a multimodal approach, not as repeated long-term monotherapy.
Compliance Recommendations
MSP recommends reviewing the payment schedule regularly, maintaining accurate and clear patient charts and ensuring all billing staff are trained on correct code usage.
MSP Anaesthesiology Billing Cheat Sheet
To make anaesthesiology billing easier, keep our MSP Anaesthesiology Billing Cheat Sheet handy! It covers:
- Guidelines and Criteria
- Common Fee Codes
- Consultations
- Visit / Evaluation:
- Call Outs & Continuing Care Premiums
- Anesthetic Procedural Fees
- Anesthetic Procedural Fee Modifiers
- Diagnostic and Therapeutic Anesthetic
- Resuscitation by an Anesthesiologist
- Obstetric Analgesia Fees
- Acute Pain Management
