This transcript has been edited for clarity.
I’m Andrew Pouw, MD, and I’m presenting at the American Glaucoma Society Meeting in Rancho Mirage, California. I’ll be presenting on late breaking policy developments for Medicare. Some of the things that we found last year [was] that Centers for Medicare and Medicaid Services surprised everybody last summer by announcing some pretty different rules to the physician fee schedule, which gets updated every year. Their proposals for how those rules would change last summer, were provocative, making 2 large, unprecedented changes for this calendar year, 2026. The two changes yield drastic cuts to physician reimbursements, which is already challenging for all of us to deal with.
The first category cuts are big, variable cuts to practice expense relative value units (RVUs) in surgical facilities. Now, some private offices get practice expense RVU boosts, but since we surgeons can’t easily do our glaucoma surgeries in an office setting, we are unfortunately site-locked and we’re all going to be seeing big decreases and cuts to our practice expense RVUs. Overall, that will be about a 10% to 14% reduction in our total reimbursement from that change alone.
The second big change is not to the practice expense RVU, but to the work RVU components—a somewhat arbitrarily decided 2.5% reduction to work RVUs for a lot of procedural and diagnostic testing. So that affects the things like we do like perimetry, OCT, and fundus photography, of course. We’re already talking about cuts to surgical procedures from what I just said earlier, and they get cut again by 2.5%.
There is a silver lining to this, at least. We had just enough time to amount a big awareness campaign and sent a lot of letters to Congress to see if they could help us appeal and stay this cut. That has yielded some support in the House of Representatives, and right now there’s a House resolution 7520 that we can all lend our support to that is trying to hold these work RVU cuts and keep the conversion factor from slipping any further.
If you all look towards your email, there's a Washington Report Express email from the American Academy of Ophthalmology that can link you to a way to appeal to your local Congressperson to support H.R. 7520. That can hopefully keep our livelihoods from being impacted any further and keep patient care intact as well. GP