Both policymakers and ophthalmic stakeholders have recognized the role that office-based surgery currently plays in delivering eyecare to seniors and its future role.
In its 2016 rule discussion, Medicare acknowledged the utilization of cataract and retina surgery in the office-based setting and asked for stakeholder feedback regarding how Medicare can officially recognize it as an office-based setting in the future:
Advancements in technology have significantly reduced operating time and improved both the safety of the procedure and patient outcomes. As discussed in the proposed rule, we believe that it now may be possible for cataract surgery to be furnished in an in-office surgical suite, especially for routine cases. Cataract surgery patients require a sterile surgical suite with certain equipment and supplies that we believe could be a part of a non-facility-based setting that is properly constructed and maintained for appropriate infection prevention and control.
The American Academy of Ophthalmology, which serves as the leading medical society for ophthalmologists in the United States, indicated in a November 2021 article that the organization would support office-based surgery with adequate safety standards:
“Some private payors may be reimbursing for cataract surgery in this setting, but Medicare currently does not, and interest expressed by members, while growing, has been limited. The Academy would support the option of office-based cataract surgery with adequate safety standards.”