Earlier this month, UnitedHealth Group (UHG) announced a policy that will take effect Oct. 1, 2025, reimbursing anesthesia services billed with the QZ modifier—those performed independently by CRNA/nurse anesthesiologists—at 85 percent of the fee schedule.
The policy excludes Arkansas, California, Colorado, Hawaii, Massachusetts, New Hampshire, and Wyoming.
UHG’s policy follows similar reimbursement cuts from Cigna, Anthem Blue Cross Blue Shield and Medical Mutual of Ohio. This policy discriminates against CRNA/nurse anesthesiologists based on licensure and conflicts with the federal provider non-discrimination provision of the Affordable Care Act. Read more in the press release here.
This issue is personal for many of us and the communities we serve. More than money is at stake—these cuts affect real people: providers, patients and the health systems that care for them, particularly in rural settings and underserved areas where CRNA/nurse anesthesiologists are often the sole or primary anesthesia providers.
As part of efforts to protect high-quality, cost-effective anesthesia care in rural communities, we would like to share these stories to highlight how these reductions in reimbursement directly impact patient access to care.
We ask you to consider how UHG’s recently announced—and other insurers’ previously announced—reimbursement reductions for independently provided anesthesia services are affecting you and your practice. Are you already seeing the effects of these cuts on care delivery, staffing or access?
Please share your stories or data by emailing info@aanadc.com
As always, thank you for all that you do and for your support.
AANA Vice President Discusses Proposed Bylaw Amendment in Beyond the Mask Podcast
Good governance is proactive, not reactive, and a potential bylaw change could help the AANA move more in that direction. In a Beyond the Mask podcast episode titled “What You Need to Know About a Potential Bylaw change,” Vice President Tracy Young, MSNA, MBA, CRNA, discusses one of the most important proposals facing the AANA: a new bylaw amendment that would establish a clear, fair process for removing a board member before a crisis demands it. Learn about what the amendment proposes, the rationale behind it, and the potential implications for the AANA moving forward.
Upcoming Webinar: Policy, Politics, and Power Plays (Presented by AANA Federal Government Affairs)
Join AANA’s Federal Government Affairs team on July 30 for a member webinar with updates on key developments in Washington, D.C., including activity in the House, Senate, White House, and federal agencies. Advanced registration is required for this webinar.
Arizona Enacts Legislation Expanding Clinical Training for RRNAs
Arizona has enacted SB 1741, a law that expands clinical training capacity for resident registered nurse anesthetists (RRNAs).
The legislation increases the capacity of preceptor training programs at healthcare institutions for RRNAs, prioritizing the development of clinical rotations in obstetrics, cardiovascular, thoracic, and neurological care.
SB 1741 directs the Arizona Board of Nursing to create a grant program that will help healthcare institutions cover direct and indirect costs related to expanding clinical training placements for RRNAs.
New Hampshire Increases APRN Positions on Board of Nursing
The New Hampshire Board of Nursing has adopted rules concerning the composition of the board of nursing, increasing the number of advanced practice registered nurse (APRN) members from one to two. The rule does not specify an APRN role for each position. In New Hampshire, APRN roles include CRNAs, as well as certified nurse practitioners, certified nurse midwives, and clinical nurse specialists.
Your Voice Matters To Your Legislators—Make Sure They Hear From You
If you haven’t already, be sure to write your U.S. legislators in support of healthcare policies important to our profession. Active CRNAdvocacy grassroots opportunities include:
Updated Tools for Safer Patient Selection in the Ambulatory Setting: HbA1C & BMI
Making informed patient selection decisions is essential for ensuring safe anesthesia care, especially when caring for patients with an elevated HbA1c or BMI.
To support your practice, two updated quick-reference infographics on patient selection in the ambulatory setting were recently released: Clinical Considerations for Elevated HbA1c and Clinical Considerations for Elevated BMI.
Curated from current recommendations, these resources offer:
Practical preoperative assessment tips
Suggested actions to guide decision-making
Concise, easy-to-use information to support patient safety
Reps. Doggett, Murphy Introduce Bipartisan Bill to Ensure Adequate Provider Payments under Medicare Advantage
U.S. Representatives Lloyd Doggett (D-TX), Ranking Member of the Ways and Means Health Subcommittee, and Health Subcommittee member Greg Murphy, M.D. (R-NC) introduced bipartisan legislation to require Medicare Advantage (MA) to adequately reimburse health care providers for services offered to enrollees of these private plans. The Prompt and Fair Pay Act establishes a floor requiring MA plans to reimburse for all covered health care items and services at least what would have been paid under Medicare Parts A and B; plans and providers may continue to negotiate higher reimbursement rates. The legislation also establishes prompt payment rules for clean in-network claims, which are requirements that would mirror those under Medicare Part D.
"We appreciate Congressman Doggett's leadership in introducing the Prompt and Fair Pay Act to ensure that Medicare Advantage plans are properly reimbursing practitioners for the care they provide," said Jan Setnor, MSN, CRNA, Col. (Ret), USAFR, NC, President of the American Association of Nurse Anesthesiology. "This bill will ensure patients have access to nurse anesthetists and other providers and the high-quality care they deliver by holding payors accountable for proper and timely reimbursement of care. This bill will protect access to care for the growing number of Americans who utilize Medicare Advantage plans, and we strongly urge Congress to pass this critical legislation."
CMS releases CY 2026 Medicare Part B Physician Fee Schedule proposed rule
On July 14, the Centers for Medicare & Medicaid Services (CMS) released the proposed CY 2026 Medicare Physician Fee Schedule (PFS).
The PFS includes payment updates for CRNA/nurse anesthesiologists and other clinicians billing Medicare Part B, and it often influences private payer fee schedules.
Beginning in CY 2026, CMS will implement two separate conversion factors:
Qualifying APM conversion factor: $20.6754 (a 1.76% increase from the CY 2025 average national anesthesia conversion factor)
Non-Qualifying APM conversion factor: $20.5728 (a 1.30% increase from the CY 2025 average national anesthesia conversion factor)
These changes to the conversion factor are due to statutory requirements under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). They also reflect the 2.5 percent increase from the One Big Beautiful Bill Act and incorporate negative adjustments to anesthesia practice expense and malpractice RVUs.
AANA continues to review the proposed rule. Staff will provide a high-level summary in the coming weeks and will submit comments on the payment adjustments and other proposed policy changes before the public comment deadline on Sept. 12, 2025.
On July 15, 2025, the Centers for Medicare & Medicaid Services (CMS) released the proposed CY 2026 Medicare Hospital Outpatient Prospective Payment System (OPPS) rule.
The OPPS sets reimbursement rates for hospitals and ambulatory surgical centers providing outpatient services and includes policies that may affect CRNA/nurse anesthesiologists.
update OPPS and ASC payment rates by 2.4% for facilities that meet applicable quality reporting requirements.
eliminate the Inpatient Only (IPO) List over the next three years.
assign Physician Fee Schedule equivalent payment rates for any HCPCS codes assigned to the drug administration ambulatory payment classifications (APCs) when provided at an off-campus provider-based department.
modify the ASC Covered Procedures List.
continue policies to provide temporary additional payments for certain non-opioid treatments for pain relief.
modify Hospital Price Transparency regulations to ensure hospitals provide meaningful, accurate information.
modify quality reporting program requirements and collect feedback via a request for information on quality measures related to well-being and nutrition.
implement a two-step process to change the overall hospital quality star rating system.
AANA’s Federal Government Affairs team is analyzing the proposed rule for potential impacts on CRNA/nurse anesthesiologist practice and reimbursement and is preparing comments. The public comment period closes Sept. 15, 2025.
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