CMS Proposal Would Cut Payment for Same-Day Injection Visits

The proposed Physician Fee Schedule for 2027 includes changes affecting intravitreal injections, E/M services, and physician payment.

By: Jim Gallagher, senior managing editor

Retinal Physician July 16, 2026

CMS Proposal Would Cut Payment for Same-Day Injection Visits

Overview

The proposed 2027 Physician Fee Schedule by CMS aims to reduce Medicare payments for same-day evaluation and management (E/M) visits associated with intravitreal injections.

Background

The proposed changes in the Physician Fee Schedule directly affect the financial viability of retina specialists. Intravitreal injections are a common procedure in ophthalmology.

Data Highlights

No numerical or trial data available in the source material.

Key Findings

The CMS proposal would reduce payment for same-day E/M visits performed on the same day as procedures with a 0-day global period, such as intravitreal injections.
Under the proposal, the higher-valued service would be reimbursed at 100%, while additional same-day E/M services would be paid at 50%.
CMS aims to address perceived duplicative payments through this proposed change.
ASRS CEO Jill Blim described the proposal as a major reduction in reimbursement for retina practices.
CMS has proposed a conversion factor decrease for qualifying APM participants and nonqualifying clinicians.
The American Academy of Ophthalmology has criticized the proposal, highlighting the challenges faced by physicians in providing care.

Clinical Implications

The proposed changes may necessitate adjustments in practice management for retina specialists.

Conclusion

The CMS proposal represents a shift in reimbursement policy.

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Retinal Physician

CMS Proposal Would Cut Payment for Same-Day Injection Visits

CMS Proposal Would Cut Payment for Same-Day Injection Visits

Overview

Background

Data Highlights

Key Findings

Clinical Implications

Conclusion

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