Reimbursement for Advanced Technology IOLs

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Topic: IOLs

Sponsor: Centricity Vision

Updated: 08/14/2024

This FAQ addresses the following:

What are advanced technology IOLs?
Who provides the AT-IOL?
Does CMS instruct providers how to charge for an AT-IOL or set limiting charges?
How is the upgrade lens charge for an AT-IOL reported on a claim?
Is it necessary to segregate the facility charges from the surgeon’s charges?
How should we tell beneficiaries about the noncovered charges associated with an AT-IOL?
Which modifiers are used with claims for AT-IOLs?
Do all payers follow CMS’ rulings for AT-IOLs?

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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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