ASCRS Advocacy Prevents Decrease in Reimbursement for Cataract Code 66984 in 2016

In the 2016 Medicare Physician Fee Schedule (MPFS) final rule, the cataract code 66984 reimbursement decreased 1% from $650.40 to $642.39 as a result of changes to the practice expense RVU. ASCRS realized that CMS had erroneously reduced the indirect practice expense for this code and notified CMS of this error. After discussions with CMS, they agreed to go back and re-do the calculations.

Today, CMS released updates to the 2016 MPFS, which include a correction to 66984. In the original 2016 final rule, the cataract code 66984 practice expense was 8.80, which resulted in the reduction to 66984. In today’s update, CMS increased the practice expense to 8.98. In the original final rule, the total RVU was 17.91. As a result of the practice expense change issued today, the total RVU has increased to 18.11.

If you have any questions, please contact Ashley McGlone at 703-591-2220.