Medicare Reimbursement for enVista® Aspire IOLs

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Topic: IOLs

Sponsor: Bausch + Lomb

Updated: 06/06/2024

This FAQ addresses the following:

How are Bausch + Lomb enVista® Aspire IOLs classified within the Medicare program?
Is a Medicare beneficiary financially responsible for any portion of these IOLs?
What additional services are required to insert or monitor an astigmatism-correcting IOL?
Prior to cataract surgery, what tests are covered?
What tests are not covered?
How are charges determined for noncovered tests?
How is the cost of the astigmatism-correcting functionality of an IOL determined?
Does Part C Medicare (Medicare Advantage) follow Part B coverage rules for toric IOLs?
Must a Medicare beneficiary sign an ABN before receiving any non-covered items or services?

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The reimbursement information is provided by Corcoran Consulting Group based on publicly available information from CMS, the AMA, and other sources. The reader is strongly encouraged to review federal and state laws, regulations, code sets, and official instructions promulgated by Medicare and other payers. This document is not an official source nor is it a complete guide on reimbursement. Although we believe this information is accurate at the time of publication, the reader is reminded that this information, including references and hyperlinks, changes over time, and may be incorrect at any time following publication.

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