5 Key Takeaways

• 1

  CMS's final 2026 OPPS rule includes a 3.3% overall increase in payment rates for hospital outpatient departments and ambulatory surgery centers.

• 2

  Intraocular level 2 and level 3 procedures will receive higher increases of 4.97% and 5.69%, respectively, exceeding the average OPPS increase.

• 3

  The APC methodology used by CMS creates disparities in payments, often underpaying complex retinal surgeries compared to their actual costs.

• 4

  71% of retina specialists report challenges in securing operating room time for emergency cases, impacting access to timely care.

• 5

  ASRS and other organizations emphasize the need for solutions to ensure Medicare patients have access to emergency retina procedures.