OMIDRIA has a unique permanent J-code
phenylephrine 10.16 mg/mL and ketorolac 2.88 mg/mL ophthalmic irrigation solution, 1 mL 7
CMS confirmed that OMIDRIA qualifies for separate payment under the non-opioid pain management policy when used in ASCs. Separate payment is effective retroactively beginning October 1, 2020 26.
- 20% co-pay in ASCs 27
- Approximately 90% of Medicare Part B patients have some form of supplemental insurance, which covers co-pays 28
Individual plan coverage, payment, policies, and procedures vary and should be confirmed by the facility. Omeros does not guarantee reimbursement.
No effect on physician or facility fees 27
Payment to the surgeon for cataract surgery under Medicare’s Physician Fee Schedule will be unaffected by the use of OMIDRIA.Learn More About OMIDRIAssure
Information contained herein is provided as a reference for obtaining appropriate and accurate reimbursement for the use of OMIDRIA in eligible patients. Omeros Corporation does not guarantee that the use of the recommended codes will result in reimbursement.