Resources to Remember
AI prompts to think better and plan well.
If you are not using AI much yet, or are consistently using it but don't have a consistent approach, here are 8 prompts to save for future use. The first 5 are especially important for thinking better, planning, and learning new topics. Wonder Tools
It's no longer IF, but WHEN for your practice.
There have been just under 40 instances of cyberattacks on optometry practices (that we know of) in 2026. It is no longer a matter of if practices will get attacked but when. It is no longer just the big organizations and large practices, but even small-town, single-provider locations. What can we do to mitigate and prepare for that risk? Aaron Werner Podcast
Articles to Apply
Should we put statins in the water for AMD prevention?
A large-scale review of studies involving nearly 2 million participants says there is low certainty and insufficient evidence for benefits or risks of statin use in patients with AMD. American Journal of Ophthalmology
Quotes to Consider
"True leadership only exists if people follow when they would otherwise have the freedom to not follow. Many business leaders think they're leading when in fact they're simply exercising power, and they might discover to their horror that no one would follow them if they had no power. If you rely primarily on rank or title or position or money or incentives or celebrity or any other form of raw power to get things done, quite simply, you've abdicated leadership." -- Jim Collins, Beyond Entrepreneurship 2.0
My Observations
CMS released the 2027 Physician Fee Schedule last week, and it takes effect January 1.
Are these changes a strike against growing medical optometry in your practice? No.
Comprehensive optometry, the complementary care that combines refractive and optical care with medical eye care, remains the optimal model. The rules for getting paid shift a little every year. The demand for the care optometry is uniquely positioned to deliver doesn’t.
Here are the three changes that matter for your practice.
Change #1: The conversion factor dropped 2.31%. But what does that actually mean?
Think of Medicare as a points system. Every code is worth a set number of points, which CMS calls RVUs. Those points reflect your time and skill, overhead, and malpractice costs.
Each year, Medicare decides what one point is worth in dollars. That’s the conversion factor. It was $33.40 in 2026 and drops to $32.63 in 2027.
The formula is simple: points × dollars per point = what Medicare pays.
If the conversion factor were the only thing to change, here’s what it would look like:
99213: 2.85 points × $33.40 = $95.19 in 2026. In 2027, 2.85 × $32.63 = $93.00.
99214: 4.06 points × $33.40 = $135.61 in 2026. In 2027, 4.06 × $32.63 = $132.48.
92133: 0.92 points × $33.40 = $30.73 in 2026. In 2027, 0.92 × $32.63 = $30.02.
Two caveats. First, CMS also revalues each code’s points every year, so a code can gain or lose a little on top of the conversion factor change. Check your specific codes once 2027 rates are loaded. Second, these are national averages. Your actual payment is adjusted for your local costs.
Change #2: Same day visit plus a minor procedure. The cheaper service gets paid at 80%.
When you bill a 99 code with modifier 25 on the same day as a procedure with a 0 day global period, Medicare pays the higher paying service in full and the other at 80%.
The commonly used 0 day procedures in optometry are corneal foreign body removal (65222), conjunctival foreign body removal (65205, 65210), epilation (67820), corneal debridement (65435), and amniotic membrane without sutures (65778). Punctal plugs (68761) and chalazion excision (67800) carry 10 day globals, so they fall outside this rule.
Which service takes the cut depends on the visit. With a 99213 ($93.00) plus a corneal foreign body removal (about $65), the procedure pays less, so it drops to about $52. With a 99212 ($58.08) plus the same removal, the visit pays less, so it drops to $46.46.
Remember: the standard for modifier 25 hasn’t changed. The visit must be significant, separately identifiable, and unrelated to the decision to do the procedure.
Change #3: G2211 becomes modifier B1.
G2211 paid a flat amount, about $17, no matter the visit level. B1 pays 16% of the visit itself. So the bigger the visit, the bigger the payment.
99214:
2026: $136 + $17 (G2211) = $153
2027: $132 + $21 (16% of $132) = $153
Break even.
99213:
2026: $95 + $17 = $112
2027: $93 + $15 (16% of $93) = $108
About $4 less.
99212:
2026: $59 + $17 = $76
2027: $58 + $9 (16% of $58) = $67
About $9 less.
The math breaks even at a visit worth a little over $100. Below that, 16% is less than the old flat payment. That’s why level 4s hold steady while level 3s and 2s take a cut.
If you’re not billing it yet, this is your best lever to recover the 2.31% cut. On ongoing glaucoma, chronic dry eye, or AMD care, B1 gives you a 16% raise on a visit you’re already doing.
As always, check your MAC’s 2027 rates.
These changes don’t shift the bigger picture. Your focus is still building consistent, sustainable systems that bring optical care and longitudinal medical care together for the whole patient.