FAQs on MIPS

Questions often asked about DEXYCU

DEXYCU is not included in the MIPS (Merit-based Incentive Payment System) for the year 2020.

EyePoint continues to work with Congress and CMS (Centers for Medicare and Medicaid Services) on behalf of our physician community and their patients in an effort to ensure DEXYCU remains excluded from the MIPS calculation in future years.

We believe DEXYCU should remain excluded from the MIPS calculation because DEXYCU treats postoperative inflammation, similar to other comparable treatments that are currently excluded from the MIPS calculation. While we can never guarantee any current pass-through product will not be subject to MIPS, we are optimistic our efforts on behalf of you and your patients will yield a positive outcome.

CMS and its contractor Acumen develop the new episode-based cost measures with physician input, including that of ASCRS (American Society of Cataract and Refractive Surgery). An ASCRS physician continues to serve on a technical expert panel, advising CMS and Acumen on the development of the cataract and other episode measures.

Should CMS decide to update a measure for a subsequent reporting year, CMS is required to post the update for public comment. The vehicle for this would be the MPFS (Medicare Physician Fee Schedule) proposed rule, which is scheduled for release in late June/early July of each year, prior to the reporting year. At that time, when the proposed rule is released, EyePoint reviews to determine whether J1095 (DEXYCU) has been added to the measure and, if so, for which ICD-10 diagnoses. If it has, then the company can submit comments to CMS with regard to the measure.

No. Once a measure is finalized for a reporting year, any additions to HCPCS (Healthcare Common Procedure Coding System) (eg, J or Q codes) or CPT (Current Procedural Terminology) codes cannot be incorporated mid-year into the measure.