SAN FRANCISCO — American Academy of Ophthalmology representatives are emphasizing the need to apply office visit Evaluation and Management code values, set to go into effect on Jan. 1, 2021, to postoperative visits as well, a speaker said here.
“One of the things that usually happens when there is a change in the value of the office visit codes, is those changes or increases usually get applied to the value of postoperative visits included in the surgical package,” David B. Glasser, MD, secretary for federal affairs of the American Academy of Ophthalmology, said at a press conference during the AAO annual meeting. That is what the AMA recommended to CMS through its RVS Update Committee.
“But this was one of the 10% to 15% of the times that CMS declined to take RUC’s recommendation,” Glasser said.
The addition of the Evaluation and Management (E/M) code value increase to postoperative visits is a top priority for AAO’s advocacy agenda for the next year, Glasser noted.
If approved, the increased E/M code values for postoperative visits would “largely restore” the 15% cut for cataract surgery reimbursement that goes into effect on Jan. 1, 2020, Cathy G. Cohen, MHSA, CAE, AAO vice president for governmental affairs, said at the conference.
The change is supported by most surgical subspecialties, as it would estimate about an additional $468 million worth of increased value to all Medicare fee-for-service physicians. About $114 million would accrue to ophthalmologists if the E/M code increases are applied to postoperative visits, Glasser said.
“That’s not an insignificant number to us and it’s not a huge number in the overall scheme of a $70 billion Medicare budget. It would not be a budget busting change,” he said.
The Academy has support in Congress to “apply pressure to make this happen” and is gaining support in the Senate for the change, he said. – by Robert Linnehan