Medicaidmedicare
June 2, 2025
ECT and Anesthesia

ECT and Anesthesia

Electroconvulsive Therapy (ECT) is considered an effective treatment modality for severe depression. While there are various medicinal treatment modalities, the default for patients suffering from severe depression is ECT, an intense electroshock modality that requires general anesthesia. The typical procedure only requires 15 minutes. It is the psychiatrist who determines how often the patient will be treated. These are considered easy cases and can be scheduled in any O.R. While they do not contribute materially to the practice’s bottom line financially, their incidence provides an interesting insight into the emotional state of American patients during what has been a rather stressful period of transition as a result of the pandemic.

ECT and Anesthesia

Share

To assess the volume of ECT cases over time, we compiled data from 10 large client practices. While the volume of ECT cases varied considerably from practice to practice, the overall trend is quite obvious, as indicated below. As you can see, the number of ECT cases doubled over a five-year period.

The expected yield per case is a function of payer mix, and this is primarily impacted by public payers, such as Medicare, Medicare HMO, Medicaid and Medicaid HMO. The overall average public payer percentage is 60%; but, for some of the practices, it is as high at 75%. Based on this, the average yield per case is about $188.

Today’s hot topic is the national budget. The U.S. House of Representatives has approved a bill that may have important implications for Medicaid and Medicare. It is unclear what impact this will have on physician fee schedules and how this may impact anesthesia practices. The national discussion is now focused on plans that have a significant influence on the American population. As indicated above, ECTs get paid currently because of these programs. We will watch with great interest the progress and shaping of the current legislation as it makes its way through the Senate and will provide updates as appropriate.