Mini glaucoma shunt reimbursement increases under new classification

Neve Ilan, Israel-Optonol announced in a prepared statement that its proprietary mini glaucoma shunt (Ex-PRESS) will be paid under a new ambulatory payment classification (APC) beginning Jan. 1, 2009.

The shunt now is assigned to APC 673 (Level IV Anterior Segment Eye Procedures), according to the published Centers for Medicare and Medicaid Services (CMS) 2009 Hospital Outpatient Prospective System Final Rule. In the hospital outpatient setting, the national average reimbursement for the shunt increased from $1476.16 to $2705.35. In the Ambulatory Surgery Center (ASC) setting, the payment increased from $949 to $1652.98.

“We are pleased that CMS reconsidered the reimbursement level to make the procedure available to Medicare beneficiaries,” said Patrick King, president of Optonol. “This will allow glaucoma surgeons access to the . . . mini glaucoma shunt in both the hospital outpatient setting and the ASC.”