Medicare on Propofol Sedation

Medicare now requires that deep sedation with propofol in the operator setting requires the involvement of an anesthesia professional such as a CRNA.

With respect to deep sedation using propofol fall fall, the new guidelines state: “An example of deep sedation would be a screening colonoscopy when there is a decision to use propofol, so as to decrease movement and improve visualization for this type of invasive procedure. Because of the potential for the inadvertent progress into general anesthesia in certain procedures, it is necessary that the administration of deep sedation/analgesia be delivered or supervised by a practitioner as specified in 42 CFR.52 (a).” The agency’s previous guidelines did not make distinctions between general anesthesia, moderate sedation, monitored anesthesia care (MAC) and analgesia, as the new guidelines do.

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