Best Anesthesia Billing Companies in Texas 2026
An anesthesia claim can look perfect and still pay wrong. A start time is missing, a QK modifier sits on a case that doesn’t meet medical direction rules, or a payer converts minutes to time units differently than your contract assumed. Anesthesia isn’t paid like an office visit: base units, time units, modifiers and a payer-specific conversion factor all feed the total, so small documentation gaps change the payment. Add Medicare, Texas Medicaid managed care and many commercial plans, and billing becomes a full-time job. This guide compares 10 anesthesia billing and revenue cycle management (RCM) options for Texas groups, separates specialists from general RCM firms, and covers what to check before you sign.
Disclosure Sirius Solutions Global publishes this guide and is one of the 10 companies listed. The list is not a ranking. Details come from each company’s public website or published news. |
In this guide: Comparison · Profiles · Sirius · Billing basics · Revenue leaks · Self-check · How to choose · Texas · Cost · FAQ
Key takeaway 1 Anesthesia pays on units, so documented times and modifiers directly affect revenue. | Key takeaway 2 Medicare’s 2026 anesthesia rate is $20.4976 for most clinicians. CMS proposes $20.2143 for 2027. | Key takeaway 3 Ask for anesthesia-specific proof, not just “we do medical billing.” |
Quick Comparison: 10 Anesthesia Billing Companies
Medicare anesthesia conversion factor, 2026 final vs 2027 proposed.
Company Profiles
1. Zotec Partners
Overview and services: National RCM firm for hospital-based specialties with an anesthesia division. Its site cites modifier, concurrency and supervision support. Consider it if: you want analytics-heavy reporting; press releases name Texas anesthesia groups among past clients. Ask: How are payer rule changes tracked? Website: zotecpartners.com
2. MedCloudMD
Overview and services: RCM and advisory for facility-based physician groups and health systems. Lists anesthesia billing, coding, denials, payer contracting and analytics. Consider it if: you are hospital-employed or multi-site and want advisory plus billing. Ask: How do coders review AI-generated suggestions? Website: medcloudmd.com
3. Coronis Health
Overview and services: RCM company with an anesthesia group that has absorbed firms such as SupportMed and Medac. Offers billing, A/R and consulting. Consider it if: you want a long-established anesthesia-only team. Ask: How many staff work Texas payers? Website: coronishealth.com/anesthesiology
4. Medusind
Overview and services: Miami-based RCM provider with an anesthesia billing and practice management line, including coding, enrollment, contract negotiation support and reporting. Consider it if: you want full RCM or only selected modules. Ask: What does its transition warranty cover? Website: medusind.com
5. nimble solutions
Overview and services: Formerly National Medical Billing Services. ASCs, surgical clinics, anesthesia groups, and merged Austin-based National Billing Partners. Consider it if: you bill both facility and anesthesia and prefer one vendor. Ask: Are anesthesia coders separate from ASC coders? Website: nimblercm.com
6. MHRCM
Overview and services: Multi-specialty billing company with Texas offices in Round Rock and Houston. Lists claim follow-up, payment posting, denials and A/R management. Consider it if: you want a Texas-based team. Ask: Who reviews anesthesia time and modifiers? Website: mhrcm.com
7. iMagnum Healthcare Solutions
Overview and services: Multi-specialty RCM company with anesthesia pages for Texas cities. Cites ASA units, time tracking, modifiers and denials. Consider it if: you run an ASC or pain practice and want an assessment. Ask: What conditions apply to any free offer? Website: imagnumhealthcare.com
8. 24/7 Medical Billing Services
Overview and services: National billing company with an anesthesia specialty page and Texas coverage. States it holds HIPAA and SOC 2 Type II attestations. Consider it if: security documentation matters to you. Ask: Can you see its SOC 2 report? Website: 247medicalbillingservices.com
9. Gryphon Healthcare
Overview and services: General RCM and consulting firm active with Texas hospitals. Lists coding, denials, federal and state IDR and Texas prompt-pay work. Consider it if: you need IDR or prompt-pay help; we found no anesthesia service. Ask: Does it have anesthesia clients, and who handles time units? Website: gryphonhc.com
10. Sirius Solutions Global
Overview and services: This guide’s publisher; a general medical billing and RCM company. See the next section. Consider it if: you want RCM with credentialing and audits. Ask: How would anesthesia time and modifiers be validated? Website: siriussolutionsglobal.com
Sirius Solutions Global: Medical Billing and RCM Support for Anesthesia Practices
Sirius Solutions Global approaches healthcare revenue cycle management with AI-powered technology and human verification. Automation flags routine issues; trained staff review the rest. Our services include medical billing and coding, advanced eligibility verification, claims and denial management, prior authorization, credentialing and re-credentialing, A/R follow-up, revenue leakage assessments, medical billing audits, and RCM reporting and workflow optimization.
For anesthesia groups and surgery centers, that means coverage checked before the case, claims that match the record, denials sorted by root cause and aged A/R worked on schedule. To be clear, we are a multi-specialty RCM company, not an anesthesia-only vendor, and we don’t cite anesthesia-specific client results here. If you need anesthesia-specific software or charge capture, ask us before you decide.
Want a closer look at your workflow? Request a medical billing audit from Sirius Solutions Global. |
What Makes Anesthesia Billing Different From General Medical Billing?
Typical anesthesia payment structure; rules vary by payer.
Concept | What to know |
Anesthesia time | Runs from patient preparation until constant attendance ends. Start and end times drive time units; payers convert minutes differently. |
Base units | Each anesthesia CPT code (00100–01999) carries base units for complexity. CMS publishes Medicare values; payers may differ. |
Physical status (P1–P6) | ASA health classes, P1 (healthy) to P6 (brain-dead donor). Some commercial payers add units for P3–P5; Medicare does not. |
Payment modifiers | AA: anesthesiologist personally performed. QK: directing 2–4 concurrent cases. QY: directing one CRNA. QX: CRNA with direction. QZ: CRNA without direction. AD: supervising more than four. They are not interchangeable. |
Qualifying circumstances | Add-on codes (99100, 99116, 99135, 99140) cover extreme age, hypothermia, hypotension and emergencies. Payment varies. |
Direction and concurrency | Medicare medical direction requires documented physician steps; concurrent case count decides the modifier. |
Payer differences | Medicare, Texas Medicaid and commercial plans differ on rounding, modifiers and conversion factors. |
2026 Medicare snapshot CMS set the 2026 anesthesia conversion factor at $20.4976 for non-qualifying APM clinicians and $20.5998 for qualifying APM participants (ASA summary). For 2027, CMS proposed $20.2143 and $20.4165 (AMA summary), partly because a temporary 2.5% increase expires. Final figures were due around November 1; confirm them. Rules: CMS Claims Processing Manual, Ch. 12. |
Where Do Anesthesia Practices Commonly Lose Revenue?
Where anesthesia revenue can slip, from documentation to A/R.
Billing challenge | Potential problem | RCM response |
Incorrect anesthesia time | Wrong time units | Documentation and time review |
Modifier errors | Incorrect claim processing | Modifier validation |
Coding inaccuracies | Rejections or denials | Coding review |
Medical direction documentation | Reimbursement issues | Documentation review |
Eligibility errors | Coverage denials | Advanced eligibility verification |
Delayed claims | Slower payment | Timely claim submission |
Underpayments | Missed reimbursement | Payment variance analysis |
Aging A/R | Delayed collections | Structured A/R follow-up |
Credentialing issues | Enrollment-related denials | Credentialing management |
Illustrative only; these steps don’t guarantee recovered revenue.
How Efficient Is Your Anesthesia Billing Process?
# | Question (tick one) | Yes ☐ No ☐ |
1 | Are anesthesia start and end times consistently documented? | ☐ Yes ☐ No |
2 | Are modifiers reviewed before claims go out? | ☐ Yes ☐ No |
3 | Are coding and documentation errors audited? | ☐ Yes ☐ No |
4 | Are payer-specific requirements monitored? | ☐ Yes ☐ No |
5 | Are denials categorized by root cause? | ☐ Yes ☐ No |
6 | Is aged A/R reviewed regularly? | ☐ Yes ☐ No |
7 | Are underpayments identified and investigated? | ☐ Yes ☐ No |
Yes answers | What it may suggest |
0–2 | Several workflow areas may need attention. |
3–5 | Consider reviewing possible RCM improvements. |
6–7 | Several key review steps appear to be in place. Keep monitoring performance. |
Informal self-check, not an audit. Request a medical billing audit.
How to Select the Right Anesthesia Billing Company in Texas
Criteria | What to verify |
Anesthesia experience | Anesthesia workflows and references |
Coding expertise | Coders who know anesthesia codes and modifiers |
Time documentation | How start and end times are validated |
Claims management | Claim scrubbing and submission |
Denial management | Root-cause analysis and appeals process |
A/R management | Aging reports and follow-up cadence |
Payer knowledge | Medicare, Texas Medicaid and your commercial plans |
Credentialing | Enrollment and re-credentialing tracking |
Technology | Reporting, automation and claim visibility |
Compliance | HIPAA safeguards and a signed business associate agreement |
Pricing | Transparent fees, contract term and exit conditions |
Communication | Named contact and regular reports |
What Texas Anesthesia Practices Should Know Before Choosing a Billing Partner
• Medicare: Texas Part B claims go to Novitas Solutions, and anesthesia follows CMS manual rules.
• Texas Medicaid: Enrollment and claims run through TMHP. Most clients are in managed care (STAR, STAR Kids, STAR+PLUS), so each plan may add its own rules.
• Commercial plans: Time rounding and modifier units vary by contract.
• Credentialing: Enrollment delays can hold claims; ask who tracks them.
• Surprise billing and prompt pay: Federal and Texas rules affect out-of-network anesthesia at in-network facilities, and prompt-pay law may not reach self-funded plans. Confirm with counsel.
• Settings: Hospital, ASC and office workflows differ in charge capture.
How Much Do Anesthesia Billing Companies Charge?
We can’t verify a standard Texas price, so we don’t quote one. Cost depends on claim volume, providers, complexity, scope, denial and reporting needs, and credentialing. Get quotes in writing.
Pricing model | How it works | Watch for |
Percent of collections | Fee is a share of payments collected | Rate, what counts as collections, minimums |
Flat monthly fee | Fixed amount per month | Volume caps and overage charges |
Per-claim pricing | Fee for each claim or case | What triggers extra charges, such as resubmissions |
Custom RCM agreement | Scope-based or blended fee | Termination, data ownership, transition fees |
Frequently Asked Questions
▸ What does an anesthesia billing company do?
It turns anesthesia records into claims: coding, time and modifier review, submission, denial follow-up and A/R, often with credentialing and reporting.
▸ How is anesthesia billing different?
Payment comes from base, time and modifying units times a conversion factor, so documented times and modifiers directly affect payment.
▸ How much does it cost in Texas?
Models include percent of collections, flat fee, per-claim or custom. We can’t verify a Texas average, so request written quotes.
▸ What are common anesthesia billing errors?
Missing times, wrong modifiers, coding that doesn’t match the record, eligibility gaps, late filing and unworked underpayments.
▸ What do AA, QK, QX, QY and QZ mean?
AA: anesthesiologist personally performed. QK: directing 2–4 concurrent cases. QY: directing one CRNA. QX: CRNA with direction. QZ: CRNA without direction.
▸ How is anesthesia time calculated?
From the start of patient preparation until constant attendance ends. Report actual minutes; unit conversion varies by payer.
▸ Why do anesthesia claims get denied?
Eligibility or authorization problems, modifier or direction errors, missing documentation, late filing and coding mismatches.
▸ Should anesthesia groups outsource billing?
It depends on volume, expertise and cost. Outsourcing eases workload, but you stay responsible for compliance, so audit your vendor.
▸ What should I look for in an RCM company?
Anesthesia coding knowledge, time validation, denial reporting, credentialing, HIPAA safeguards with a BAA, and clear pricing.
▸ Does Sirius Solutions Global offer RCM support?
Yes: billing, coding, eligibility, claims and denial management, prior authorization, credentialing, A/R, audits and reporting. We are multi-specialty, not anesthesia-only.
Disclaimer This article is general information, not legal, financial, coding, billing or medical advice. Payer rules, CPT® codes (© AMA) and fee schedules change, so confirm with CMS, TMHP, your payers and qualified counsel or certified coders. Company details come from public sources as of November 2026 and are unaudited. Listing is not endorsement or ranking. Sirius Solutions Global is listed and has a financial interest. No result is guaranteed. To request a correction, contact us through our website. |
