CMS Proposes Permanent Medicare Payment for Samsara Vision’s Telescope Implant for Macular Degeneration
– Beneficiary access to vision-restoring device will improve under the Medicare agency’s proposed pathway for permanent reimbursement –
Saratoga, CA – July 9, 2013
Samsara Vision Ophthalmic Technologies, Inc., today announced the Centers for Medicare and Medicaid Services (CMS) has proposed to provide reimbursement for Samsara Vision’s Implantable Miniature Telescope (by Dr. Isaac Lipshitz), the first FDA-approved ophthalmic telescope implant indicated to improve vision in patients with end-stage age-related macular degeneration (AMD), in 2014. The announcement was included as part of CMS’ CY 2014 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgery Center (ASC) Payment System proposed rule.
According to the proposal, CMS would assign the telescope implant procedure (CPT® code* 0308T) to a new Ambulatory Payment Classification (APC) 0351, Level VII Anterior Segment Eye Procedures, with mean cost calculated using claims data available for the final rule. If finalized, the new APC would be effective January 1, 2014.
“We are encouraged by CMS’ proposal to create a new clinical APC for the telescope implant procedure beginning in January 2014 to solidify patient access,” said Allen W. Hill, CEO of Samsara Vision, “Over the course of the last year, Samsara Vision has provided important data to CMS on the cost and use of the device to treat patients with severe vision loss due to end-stage AMD.”
At present, the telescope implant procedure is reimbursed under a transitional pass-through payment mechanism that will expire on December 31, 2013. Samsara Vision is continuing to analyze this proposal and intends to submit comments to CMS as part of the rate-setting process.
About the CentraSight Treatment Program
The first-of-kind telescope implant is integral to a new patient care program, CentraSight, for patients with end-stage macular degeneration. The CentraSight treatment program involves a patient management process and access to reimbursement information for patients and physicians. The telescope implantation is performed by a specially trained ophthalmic surgeon as an outpatient procedure.
Patients and physicians can find more information about the telescope implant and related treatment program at www.CentraSight.com or 1-877-99-SIGHT.
About the Telescope Implant
The Implantable Miniature Telescope (by Dr. Isaac Lipshitz) is indicated for monocular implantation to improve vision in patients greater than or equal to 75 years of age with stable severe to profound vision impairment (best-corrected distance visual acuity 20/160 to 20/800) caused by bilateral central scotomas (blind areas) associated with end-stage AMD. This level of visual impairment constitutes statutory (legal) blindness. Smaller than a pea, the telescope is implanted in one eye in an outpatient surgical procedure. In the implanted eye, the device renders enlarged central vision images over a wide area of the retina to improve central vision, while the non-operated eye provides peripheral vision for mobility and orientation.
The risks and benefits associated with the telescope implant are discussed in the Patient Information Booklet available at www.CentraSight.com.
About Samsara Vision
Samsara Vision Ophthalmic Technologies, Inc., headquartered in Saratoga, CA, is a privately-held company focused on development, manufacturing, and marketing of implantable ophthalmic devices and technologies that are intended to significantly improve vision and quality of life for individuals with untreatable retinal disorders. Samsara Vision’s Implantable Miniature Telescope was invented by company founders Yossi Gross and Isaac Lipshitz.
*CPT copyright 2013 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.
Released July 9, 2013