How Anaesthetic Fees Are Charged
When organising surgical procedures, out-of-pocket fees can be an added concern at an already stressful time. To help you plan for an upcoming procedure, we’ve provided information about anaesthetic fees and some answers to patients’ common questions.
The fees for anaesthesia are separate from the fees charged by any other doctors or the hospital where you have your procedure. The complexity and duration of your procedure will determine the fee charged and it’s your responsibility to pay your anaesthetist for the services provided.
For more detailed information about anaesthetic fees, please read the answers below, or download the Australian Society of Anaesthetics Information Sheet.
The process of calculation of fees for anaesthesia services is much like a taxi fare. There’s a base “flagfall” fee depending on the nature and complexity of your procedure. There’s also an allowance for how long the procedure takes as well as other modifiers depending on additional factors related to the patient, the procedure or its timing.
The total fee is calculated as a number of “units”, with the dollar value calculated on the unit value chosen by your anaesthetist. Recommended unit values are set by anaesthetic professional groups including the ASA and AMA. Most fees are based on but less than the ASA unit value.
As the anaesthetic fee will vary depending on the length of time your procedure takes, it’s not possible to give an exact quote for the cost of the anaesthetic services provided to you. Nevertheless, we can provide a fee estimate for you prior to your procedure if desired. If you would like an estimate, please call our office on 8139 0600 during our business hours. If you have any concerns about this estimated fee, you can discuss them with your anaesthetist on the day or prior to your anaesthesia.
You may be able to access a rebate for your anaesthetic through Medicare. If you have private health insurance, you may also receive an additional rebate from your insurer. This varies significantly between different insurers; check the specific policy arrangement between you and your insurer to find out whether you’re covered.
In consequence there is often a gap amount between the anaesthesia fee and any rebates paid by Medicare and private health funds. It is your responsibility to pay to your anaesthetist any gap amount, in addition to your Medicare and private health fund rebates.
Government legislation and private insurance company regulations prevent Australian patients from insuring against the full cost of medical fees. In addition to this, the Commonwealth Government has not indexed Medicare rebates adequately since their inception.
Government sets the rebate it pays depending on its budget allocations for any given year, and indexation has failed to keep pace with the Consumer Price Index (CPI) over the last 30 years. To put this in perspective, over this period of time, average weekly earnings have increased approximately 11 fold, and the Consumer Price Index (CPI) has increased 7 fold. In comparison, the Medicare Scheduled Fee, on average, has only been raised by the Government by less than 4.7 times over the same period.
The Medicare Schedule of Fees is a regulated list of rebates that the Government pays to patients for services provided to them by doctors. It’s not a list of fees that doctors can charge and the rebates bear no economic relationship to the true cost of provision of service. Government regulated rebates and suggested fees for anaesthesia services do not reflect the minimum of 14 years of training or the medical and legal responsibilities that the specialty of anaesthesia requires.
Our anaesthetists work as individual practitioners and as such fees vary, with each specialist determining their own fee schedule.