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CMS issues guidance on rulings regarding non-covered services
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The Centers for Medicare and Medicaid Services issued guidance regarding established Medicare reimbursement policies for cataract surgery, stating in a news release that “Medicare will cover and pay for the cataract removal and insertion of a conventional intraocular lens.”
The CMS news release, issued in reaction to potentially misinterpreted information disseminated by an ophthalmology practice, reiterated the intent of Rulings 05-01 and 1536-R, which consider when beneficiaries would pay for additional charges in relation to cataract surgery.
“These rulings allow facilities and physicians to charge patients only for the non-covered portion of a service that is furnished at the same time as a covered service,” the release said. “Services that are part of cataract surgery with a conventional lens, including but not necessarily limited to the incision by whatever method, capsulotomy by whatever method, and lens fragmentation by whatever method, may not be charged to the patient.”
Medicare coverage and payment for cataract surgery is the same, regardless of whether the surgery is performed with a conventional or a bladeless, computer-assisted laser technique, the CMS release said.
“This guidance does not apply to the use of technology for refractive keratoplasty,” the release said.