Protect your MIPS Cost score – Ophthalmology Management

A great deal has been written about CMS’ Quality Payment Program and MIPS, and we are not going to rehash all of that here. However, in 2019, we are faced with a brand new episode-based cost measure for ophthalmology — Routine Cataract Removal with IOL Implantation — that will impact many practices’ MIPS Cost score. Read on for the details.

This article addresses the following questions:

  • What is an episode-based cost measure?
  • How does this apply to cataract?
  • What costs are included?
  • What costs are excluded?
  • Surgery performed at a HOPD has considerably higher costs than an ASC. Do HOPD-based surgeons always take a hit?
  • What can we do to minimize our costs?

This article was published in Ophthalmology Management’s Coding & Reimbursement column, which is written by Corcoran’s Executive Vice-President, Suzanne Corcoran, COE. To view the entire article in Ophthalmology Management, click on the link below:;-reimbursement

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