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Intraocular ASC payments

This article was originally published in The Gray Sheet

Executive Summary

CMS should reduce payments for IOLs based on lens material, according to an 1HHS Office of Inspector General report. The document finds that the current $150 ambulatory surgical center payment rate overpays for the intraocular lenses, since the "highest cost" soft acrylic, "most frequently used" silicone and "lowest cost" PMMA IOL lenses have respective average costs of $125, $69 and $39, based on claims data for the 12 months ending June 2002. CMS has agreed to take the report into account when it revamps the ASC system, as required by the Medicare reform law...
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