About 13% of ophthalmology claims are denied. This guide covers why revenue cycle management matters for ophthalmology, the billing rules and payer guidelines you need to know, and the best practices that protect your revenue.
In this video:
✅ Why RCM matters: one visit can include an eye exam, OCT, fundus
photography, injections and same-day surgery
✅ Coding & modifiers: RT/LT/50, 58/78/79, 24/25 and quarterly NCCI edits
✅ Documentation: full-scope eye exams (92002–92014) and drug, dose, NDC and not number for injections
✅ Prior authorization for anti-VEGF injections, and the 11% 2026 Medicare cut to CPT 66984
✅ Best practices: modifier checks, eligibility and auths, denial and
underpayment tracking, monthly KPIs Results with MediBillMD: 98% clean claims rate, 97% first pass ratio, 96%
collection ratio, under 30 days in A/R and a 10–15% revenue increase. Rated Excellent on Trustpilot.
Chapters:
0:00 Intro
0:13 Why RCM matters for ophthalmology
0:39 Billing rules & payer guidelines
1:25 Best practices
2:04 Results & Trustpilot rating
2:29 Schedule a consultation
📅 Schedule a consultation: https://medibillmd.com/specialties/ophthalmologybilling-services
📖 Read the full guide: https://medibillmd.com/blog/ophthalmology-revenuecycle-management-guidelines/
📞 (877) 353-9542
✉️ info@medibillmd.com
#OphthalmologyBilling #RevenueCycleManagement #MediBillMD
