What is the Medicare reimbursement for cataract surgery?

What is the Medicare reimbursement rate for cataract surgery?

In July, the CMS released a proposed rule that will affect the Medicare Physician Fee Schedule for 2020. If the rule is finalized as is, reimbursement for cataract surgery (CPT code 66984) will be reduced from $654.47 to $557.58—a 15% cut in payment with no changes in the requirements or costs of the procedure.

What is the reimbursement for cataract surgery?

Per the proposed payment rule, reimbursement for non-complicated cataract surgery (CPT code 66984) will drop from the current level of $654 down to an estimated $557, and complex cataract surgery (CPT code 66982) will also fall from $813 in 2019 to an estimated $766 starting Jan. 1, 2020.

Is there a Medicare rebate for cataract surgery?

If you use health services in the private health system (i.e. for cataract surgery), Medicare will subsidise some (i.e. 75% of the MBS rate) of your care costs for the surgery. Medicare pays the benefit of 85% of the MBS rate for services provided outside of a hospital (i.e. a consultation).

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What is the average cost of cataract surgery per eye?

Without insurance, the average cost of cataract surgery is between $3,500 and $7,000 per eye in the United States. However, Medicare and private insurance plans often cover all, or a portion of the costs, which can reduce your out-of-pocket expenses by 80 percent or more.

How do I bill Medicare for post op cataract surgery?

After the optometrist has seen the patient for post-operative care, he/she will submit a claim for the post- operative care provided, using the appropriate CPT Code, i.e, 66984, and Modifier 55.

How do you bill Goniotomy for cataract surgery?

Use CPT 65820 (Goniotomy).

Does Medicare Part B cover cataract surgery?

Medicare Part B covers outpatient and other medical costs. If you have Original Medicare, your cataract surgery will be covered under Part B. Part B also covers doctor’s appointments like seeing your eye doctor before and after the cataract surgery.

How do I find out what Medicare procedures pay?

For general information on what Medicare covers, visit Medicare.gov, or call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.

Does Medicare pay for cataract surgery with astigmatism?

Medicare usually determines that astigmatism correction is not a covered procedure since this can be corrected with glasses.

Does Medicare cover secondary cataract surgery?

Does Medicare cover all items and services associated with cataract surgery? A. No. Most items and services associated with routine cataract surgery are covered under Medicare’s national policy.

Does Medicare pay for laser cataract surgery in 2020?

Medicare will cover 80% of the cataract removal and basic lens whether the procedure is conventional or bladeless with a computer-controlled laser. Similar to conventional surgery, laser surgery requires you to pay the additional costs if you require an advanced lens.

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