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
July 15, 2026
4 min

Retinal Physician

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.