Every year the Centers for Medicare & Medicaid Services (CMS) and other major commercial payers publish and implement coding and reimbursement updates.
Here are two updates that went into effect Jan. 1 that every young ophthalmologist needs to know about.
E/M Codes
All health care services use the revised evaluation and management (E/M) documentation guidelines.
The appropriate level of E/M code is now based on the level of medical decision-making (MDM) or time spent on the date of the encounter. The only exception is for emergency department services where time is not a descriptive component. Just choose based on medical decision-making.
Medicare Physician Fee Schedule
The Medicare Physician Fee Schedule for ophthalmology will see an overall 1.5% payment cut for 2023. It was not the best news of the new year, but it was not as bad as it could have been. A 1.5% decrease is better than the 8.5% cut estimated in November 2022.
Lean Tips to Keep You Competitive
AAOE® has committed to providing advice and tips to keep you competitive throughout 2023 with helpful advice throughout the year. Visit the Academy’s 52 Weeks of Lean webpage for tips and strategies you can use to improve efficiency and maximize profitability. We’ll be adding more as the year progresses.
Further Resources
E/M 2023 — Starting Jan. 1, Streamlined Rules Apply Beyond the Office Setting
2023 Medicare Fee Schedule
Countdown to a New Year — Tips to Prepare for a Streamlined Revenue Cycle