Reimbursement for DURYSTA
DURYSTA (bimatoprost implant) is a biodegradable anterior segment implant drug delivery system, containing 10 mcg of the drug. The Food and Drug Administration approved DURYSTA in March 2020.
This FAQ addresses the following:
- What is DURYSTA™?
- What are the indications for DURYSTA?
- What CPT code describes the insertion of the DURYSTA implant?
- How is the supply of DURYSTA coded?
- Do Medicare and other third party payers cover DURYSTA and its implantation?
- If DURYSTA and its implantation are not covered, who is financially responsible?
- Does DURYSTA need an NDC number on a claim for reimbursement?
- CPT code 66030 is designated as a “separate procedure”. What is the significance of this designation?
- Is 66030 bundled with other ophthalmic services?
- What is the surgeon’s reimbursement for 66030?
- What is the ASC or HOPD facility reimbursement?
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