Office-Based Anesthesia Rules

Physicians who provide or perform procedures involving Level II–IV anesthesia services in an outpatient setting, including the use of analgesics and anxiolytics, are required to register with the Texas Medical Board (TMB). The biennial registration fee is $210 per physician and is combined with the license renewal process. The OBA rules define four levels of anesthesia, each with escalating requirements for personnel, equipment, monitoring, and emergency preparedness. For example, Level I covers minimal sedation with oral agents or nitrous oxide/oxygen, while Level IV covers deep sedation, general, or regional anesthesia and requires compliance with current American Society of Anesthesiologists (ASA) standards. Physicians must also notify TMB within 15 days if a procedure results in an unanticipated hospitalization longer than 24 hours or a death occurring intraoperatively or within 72 hours postoperatively. Registered OBA locations are subject to inspection, by the Texas Medical Board, with at least five days’ notice provided.

For the complete and most current information, please visit the Texas Medical Board’s Office-Based Anesthesia page:

https://www.tmb.state.tx.us/apply-renew/physician/additional-practice-topics-physicians

For questions related to Office Based Anesthesia please reach out to info@tsa.org Include “Office Based Anesthesia” in the Subject line of the email.

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