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Medicare Fee Schedule Change

Earlier this month the Centers for Medicare and Medicaid Services (CMS) released Transmittal R1435CP updating the 2008 Medicare Physician Fee Schedule. One change applies to ophthalmology and corresponds to the new CPT code 67113 – Repair of complex retinal detachment.

The fee schedule update increases the work relative value units (RVUs) to 25.00; this increases the payment from approximately $1,284 to $1,405. Some contractors have been paying at the appropriate rate while others have not. The change is retroactive to January 1, 2008.

It is important to review claims paid-to-date and determine if you were paid correctly. If you were not paid correctly, you may seek additional reimbursement on previously processed claims.

The complete CMS transmittal can be found at

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