Medicare Physician Fee Schedule 2008

The Medicare Physician Fee Schedule, published November 1, 2007, contains the expected update of –10.1% with a conversion factor of $34.0682. Ophthalmology expects a –9% reduction. CMS-1385-FC makes public the revisions to physician payment policies for 2008 and other Part B payment policies. The faulty sustainable growth rate (SGR) formula continues to be the source of the problem and no current plans exist to fix it. In prior years, Congress intervened and the dramatic cuts were averted; we expect aggressive lobbying to once again avert this extraordinary reduction.

On a positive note, the relative value units (RVUs) associated with some ophthalmic services increase in 2008. The ophthalmology codes (920xx) RVUs, overlooked in 2007, show a positive change for 2008. Corneal topography (92025) realizes a small increase. Surgical codes 66984 (cataract surgery) and 66821 (YAG laser capsulotomy) decrease.

If implemented in its current form, the following changes in reimbursement (2007 compared with 2008) can be expected.

  • Eye Exam (92014) nil
  • Eye Exam (92012) 1%
  • E/M Level 3 (99213) -11%
  • SCODI (92135) -11%
  • YAG capsulotomy (66821) -12%
  • Cataract surgery w/IOL (66984) -13%
  • SLT (65855) -14%

The Federal Register publication date is planned for November 27, 2007. Stay tuned for future changes.

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