Seattle and Seratoga, CA—The Center for Medicare and Medicaid Services (CMS) has granted billing and reimbursement statuses to products from Omeros Corp. and VisionCare Ophthalmic Technologies, respectively.
Omeros received transitional pass-through status for its lead product, phyenlephrine and kerotorolac injection (Omidria 1%/0.3%) from CMS.
Approved earlier this year by the FDA for use during cataract surgery or IOL replacement, the drug treatment is the only FDA-approved product for intraocular administration that prevents intraoperative miosis and reduces postoperative pain, according to the company.
Transitional pass-through status will allow ambulatory surgery centers and other outpatient facilities to bill Medicare and other insurance providers for the drug treatment using a temporary Healthcare Common Procedure Coding System code unique to the product.
Pass-through status for the drug treatment will become effective on Jan. 1 and reimbursement will be based on the product’s wholesale acquisition cost of between $400 and $500 per single-use vial.