Anthem Blue Cross Blue Shield has published an updated Professional Anesthesia Services Reimbursement Policy announcing that as of November 1, 2024, in at least 14 states, it will reimburse anesthesia claims billed with modifier QZ, reflecting claims for services provided by certified registered nurse anesthetists without physician medical direction, at 85 percent of full physician rates. The change in policy has been opposed by the American Association of Nurse Anesthetists.