Despite gain from eye code increases, ophthalmologists face possible cut in physician reimbursement

NEW ORLEANS — Ophthalmologists will receive higher Medicare eye code payments in 2008 but may face a significant cut in physician payments, an American Academy of Ophthalmology official announced.

In a news conference at the AAO meeting here, William C. Rich, MD, AAO legislative advocate, described how ophthalmologists stand to gain — and lose — under the 2008 Medicare Physician Fee Schedule. The Centers for Medicare and Medicaid Services issued a final rule on the fee schedule Nov. 2.

Ophthalmologists' Medicare payments will rise about 2%, or $154 million, because of the eye code increases. However, a 10% reduction in physician payments stemming from the standard growth rate (SGR), a key factor in physician payments, may offset the code increases, Dr. Rich said.

He voiced cautious optimism that Congress will forestall the 10% physician payment cut.

A bill passed in the House of Representatives in September proposed replacing the SGR with a set of six new payment targets. President Bush vetoed the bill, which also called for large increases in children's medical coverage. A similar bill is under consideration in the Senate.

Because of the eye code increases, ophthalmologists will still gain more than other surgical subspecialists, even if the Senate bill is not passed and the SGR is not eliminated, Dr. Rich said.

"We anticipate that ophthalmologists will certainly do better than any other surgical subspecialty" in 2008, he said. "Even if the Senate bill doesn't pass, we still get a cut less than 10%. For us, it'll be about 8%."

In a subsequent interview with Ocular Surgery News, Catherine Cohen, AAO legislative affairs secretary, echoed Dr. Rich's assessment of how ophthalmologists stand to gain from the eye codes.

"The big, good news is that on Jan. 1, ophthalmology will be in the best position of any surgical specialty, thanks to the boost in the eye codes," Ms. Cohen said.