Ophthalmology and Optometry Coding Alert

Slated 4.5% cut averted by new Medicare bill

CMS offered ophthalmologists an early holiday gift this year. Despite earlier reports of a 4.5 percent conversion factor decrease, CMS announced a last-minute increase, raising the conversion factor by 1.5 percent for 2004 and 2005.
 
Thanks to the Medicare Prescription Drug and Improvement Act, approved by Congress on Nov. 25, the conversion factor, which was 36.7856 in 2003, will rise to approximately 37.3373 (CMS has not released the new rate's exact amount).
 
"Passage of the Medicare bill is a historic victory for Medicare patients and their physicians," said AMA President Donald J. Palmisano, MD, in a Nov. 25 press release.
 
This is particularly good news for ophthalmologists, because CMS did not increase relative value units (RVUs) for most ophthalmology procedures. In fact, Medicare decreased the RVUs for many services (see chart below) and did not change the RVUs for most others.