PR-194: Anesthesia by Operating/Assistant/Attending Physician

What Does PR-194 Mean?

With PR (Patient Responsibility), the patient is charged for the anesthesia that the payer considers included in the surgical fee. This is uncommon — verify whether the claim should be corrected before billing the patient.

CARC 194 indicates that anesthesia services were billed separately but the payer determined they were performed by the operating physician, assistant surgeon, or attending physician rather than a dedicated anesthesia provider (anesthesiologist or CRNA). Most payers consider anesthesia by the surgeon to be included in the surgical payment and do not pay for it separately.

This code commonly appears when anesthesia claims are submitted without proper provider identification or modifiers to distinguish who administered the anesthesia. If a separate anesthesia provider (anesthesiologist or CRNA) actually performed the anesthesia, the claim needs to be corrected with the appropriate provider information and modifiers.

How to Resolve

1. Verify the anesthesia provider Confirm whether a separate anesthesia provider was involved.
2. Correct the claim if possible If a separate provider performed the anesthesia, correct the claim and request reprocessing.
3. Collect from the patient if confirmed If the surgeon performed the anesthesia and the charge is correct, communicate the amount to the patient.

How to Prevent PR-194

• Verify anesthesia billing accuracy before submitting claims that may result in patient charges

Also Filed As

The same CARC 194 may appear with different Group Codes:

Related Denial Codes