Coding and Billing

6 Medicare Changes for 2023 that Will Impact Your Patients & Practice

By Mark Wright, OD, FCOVD,
and Carole Burns, OD, FCOVD

Nov. 2, 2022

Changes to Medicare are coming in 2023 that will affect your patients and your reimbursement for services.

Medicare makes changes every year, and you need to be aware of these changes, as well as make whatever changes in your practice are necessary as a result. Here is a list of the most important changes for this coming year.i

  • Part A premiums, deductible and coinsurance all increase in 2023.
  • The standard Part B premium is decreasing from $170.10/month to $164.90.
  • The Part B deductible is decreasing from $233 to $226.
  • The income brackets for high-income premium adjustments for Medicare Parts B and D will change from $91,000 to $97,000 next year.
  • The Part D donut hole no longer exists next year, but …
    • A standard plan’s maximum deductible will increase to $505 next year.
    • The threshold for entering the catastrophic coverage phase out will increase to $7,400.
    • The Inflation Reduction Act ensures that Part D enrollees no longer have to pay for vaccines.
    • Part D enrollees are covered for insulin for no longer than $35/month.
  • Medicare Advantage enrollment is expected to increase in 2023, however, the average premiums are decreasing.

Based on this information, here are a five changes you should make in your practice:

  1. Review your third party systems every November and plan for changes that happen the next year.
  2. Review reimbursement and third-party policies to make sure you are maximizing what you are entitled to.
  3. Schedule your Medicare patients later in the year after their deductibles have been met.
  4. Patients often do not give you all of their insurance information, so make sure you collect all of each patients’ insurance information – not just their vision insurance.
  5. Many doctors wait too long to submit claims due to not paying the appropriate attention to the task. There are time limits on submitting claim insurance claims, so put systems in place to be able to submit third-party claims the same day or no later than the next day.

i How are Medicare benefits changing for 2023? (

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