Cataract Surgery Co-Management Billing Changes

In January of 2020 there were significant changes to cataract surgery billing, including new codes and price adjustments. These changes have had a direct impact on the co-management optometric payments. At Fraser Eye, we want to make sure that all of the providers we work with have the information they need because we know that when administration runs smoothly, we can keep the focus on patient care.

Details on Billing Changes for Cataract Surgery

Effective January 1st, 2020, the reimbursement for a non-complicated cataract surgery with IOL (CPT code 66984) was reduced from $654 to $558. Complex cataract surgery with IOL (CPT 66982) was reduced from $813 to $766. This represents a 15% and 6% reduction in payment, respectively, as well as reduced co-management fees.

Additionally, new CPT codes for cataract surgery with Endoscopic cyclophotocoagulation (ECP) have been released. Non-complicated cataract surgery with IOL and ECP is CPT 66988 and Complex cataract surgery with IOL with ECP is CPT 66987 – both of these are co-manageable.

One thing to note is that CMS has left the various individual MACs responsible for setting payment for the new Cataract + ECP codes, which has left some MACs reimbursing less for the combined codes than the individual cataract code separately. At this time, we do not know how those numbers will exactly settle out in Michigan so please stay tuned.

Fraser Eye changes to documentation

To help our co-managing doctors handle these changes, you will soon see all 4 CPT Cataract surgery codes in our final cataract dictation sheets with the proper CPT code checked off for each individual eye and surgery.

Contact Fraser Eye

We appreciate the opportunity to work with many dedicated eye care professionals in the Detroit area, and we are always here to answer questions about co-management and patient care. Feel free to contact uscontact us with any questions.