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Non-opioid OMIDRIA qualifies for separate payment by the Centers for Medicare & Medicaid Services (CMS) when used in ambulatory surgery centers (ASCs)1

OMIDRIA is covered and paid by 100% of Medicare Administrative Contractors in ACSs across all 50 states and Puerto Rico

OMIDRIA has a unique billing code: J1097
Phenylephrine 10.16 mg/mL and ketorolac 2.88 mg/mL ophthalmic irrigation solution, 1 mL3

OMIDRIA is reimbursed per mL; therefore, providers should always use 1 mL as the billing unit and bill for 4 units when a full vial of OMIDRIA is utilized.

Go to OMIDRIAssure®, Support at every step

The OMIDRIAssure® program offers patients options to assist with the cost of OMIDRIA:

We Pay the Difference patient reimbursement program for commercially insured patients

Equal Access patient assistance program for government-insured or uninsured patients (based on financial need)

Dedicated access to comprehensive reimbursement programs for your cataract procedures:

Field Reimbursement Managers to help you navigate through the reimbursement pathway

Schedule an in-service with your OMIDRIA Field Reimbursement Manager by contacting your OMIDRIA Sales Representative or call 1-877-OMIDRIA (1-877-664-3742) 9 AM-5 PM ET, Monday-Friday.

Contact us about access and reimbursement.

REFERENCES: 1. US Department of Health and Human Services. Medicare program: hospital outpatient prospective payment and ambulatory surgical center payment systems and quality reporting programs; price transparency of hospital standard charges; radiation oncology model; request for information on rural emergency hospitals. Fed Regist. 2021;86(147):42018-42360. 2. Centers for Medicare & Medicaid Services. ASC Payment Rates – Addenda. Updated September 23, 2021. Accessed September 29, 2021. 3. Centers for Medicare & Medicaid Services. HCPCS October 2021 Index. Accessed September 16, 2021.