Second Sight Medical Products announced that the Centers for Medicare & Medicaid Services (CMS) finalized its Medicare hospital outpatient payment rate of $150,000.50 for calendar year 2017. The payment for the surgical procedure includes the cost of the Argus II Retinal Prosthesis System.
In addition, the company announced that the American Medical Association (AMA) Current Procedural Terminology (CPT) editorial panel approved two new Category 3 CPT codes for initial programming and subsequent reprogramming of the Argus II.
These CPT codes will be used by clinicians to report and bill for custom programming and reprogramming the Argus II to meet the unique needs of each patient. With the addition of these two new CPT codes for postoperative programming and reprogramming services, clinicians will be able to report and bill all services relating to implantation and programming the Argus II. The new CPT codes will be published on January 1, 2017 and can be reported by clinicians beginning on July 1, 2017. Previously, the company obtained a Category III CPT code for the implantation procedure.
"We are very pleased that we have had the support of the American Academy of Ophthalmology in achieving these important milestones in our reimbursement strategy. With the AMA CPT Editorial Panel's approval of the two new CPT codes, the billing process is simplified. Our clinicians will be able to simply report one of these new codes to bill for custom programming and reprogramming the Argus II after implantation. In addition, with CMS' announcement of the 2017 hospital outpatient payment rate, the hospitals will be more appropriately reimbursed for providing this important service to blind RP patients," said Will McGuire, President and CEO of Second Sight.