Proposed rule hurts ophthalmology ASCs, says AAO

Why This Topic Matters

The proposed rule could affect where ophthalmic procedures are performed, how ASCs are paid, and which services are considered eligible for ASC payment. Readers need this context to understand the policy issues and code-set references involved in Medicare outpatient and ASC reimbursement.

Article Sections

1. Proposed 2009 ASC rule and AAO concerns

   Introduces the CMS proposed rule and the AAO’s objections related to ophthalmic ASC reimbursement and facility access.

2. Payment disparity between OPPS and ASC rates

   Discusses differences between outpatient hospital and ASC payment methodologies and the broader effects on ophthalmic services.

3. Inpatient-only list and ASC eligibility

   Addresses CMS decisions about procedures included or excluded from ASC coverage and the concerns raised about transparency.

4. Device-intensive procedures and glaucoma shunt

   Covers device-intensive policy issues affecting ophthalmic procedures and the impact on ASC payment for selected services.

5. Unlisted ophthalmology codes

   Reviews the discussion of unlisted ophthalmic procedures and whether they should be eligible for ASC payment under CMS policy.