Advanced Ledger - Anesthesia Billing

This document will explain how to bill anesthesia charges in MacPractice.

This involves two parts:

  • Setting up your Fee Schedule
  • Entering the charge on the patient's ledger

Note: Anesthesia billing is not available in MacPractice DC.


Before you begin using anesthesia billing, you must make sure that your anesthesia fees are set up correctly in your fee schedule.

Go to References, select Fee Schedules in the sidebar, then select your fee schedule and your anesthesia fee. Change the Fee Calculations pop-up menu to Units and the Unit Type pop-up menu to Minutes.


Select the Specialty tab and check the Anesthesia checkbox to enter your unit information.

  • Base Units: The initial anesthesia amount used to induce an anesthetic state
  • Minutes/Unit (Hour 0-4): Indicates the number of minutes per unit for the first 4 hours of anesthesia
  • Minutes/Unit (Hour 4+): Indicates the number of minutes per unit for every hour after the first 4 hours of anesthesia


Once you set up your anesthesia fees in your fee schedule, you can begin billing anesthesia charges in the patient's ledger. Go to the ledger and open a New Charge window. Once you have selected the anesthesia fee, you will notice that an Anesthesia tab has appeared next to your Diagnosis, Specialty, Notes and Rx tabs.


You can then enter the times of your anesthesia and MacPractice will calculate the number of units. Remember to use the 24-hour clock to enter the time, also known as military time.

Examples:In this example the anesthesia time is from 12:00 p.m. to 3:00 p.m., or 12:00 to 15:00 military time. Since this only is 3 hours, the increments are 15 minutes per unit. The total minutes are 180, yielding 12 units. Then, the 4 base units are added to the calculated units, giving a total number of 16 units.

12 + 4 = 16

In this next example, the anesthesia time is from 12:00 p.m. to 6:00 p.m., or 12:00 to 18:00 military time. Since this is over 4 hours, the increments of the first 4 hours are calculated at 15 minutes per unit and the last 2 hours are calculated at 10 minutes per unit. The total minutes from the first 4 hours is 240, giving us 16 units. The total minutes from the last 2 hours is 120, giving us 12 units. The four base units are then added to the calculated units, giving a total number of 32 units.

12 + 16 + 4 = 32

MacPractice also allows for multiple time entries per anesthesia, in which case you can use the Time 2 and Time 3 Start and End fields.

Detecting Conflicts
Your office will also be able to check for time conflicts with other anesthesia procedures with the same provider. To enable this feature go to the MacPractice Preferences > Ledger > New Charge and check the Validate Anesthesia Times checkbox.


When the New Charge window is open, you will see a Detect Conflicts button on the Anesthesia tab. Clicking this button checks for conflicting times on the same date of service for the same provider to ensure accurate billing. An alert will appear with the conflicting patient name and code if a conflict is detected, allowing you to take the proper steps to remedy the conflict.

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