Office-Based Procedures Are Gaining Ground — What the 2026 Site-of-Service Payment Shift Means for Ophthalmology and Optometry Practices

Section analysis by Elizaveta Bannova, CPC, CPCO, CPMA, CFPC, Billing Department, WCH 

Editorial note: This article reflects CMS Physician Fee Schedule and site-of-service payment differential data current as of summer 2026, incorporating analysis published in ophthalmology and optometry practice management media. Individual payment rates vary by geographic adjustment, payer mix, and contract structure. This article is for informational and educational purposes and does not constitute financial or compliance advice.

Summer 2026 practice management analyses are documenting a pattern that ophthalmology and optometry billing teams have been tracking with growing attention: non-facility settings are showing payment gains relative to facility-based procedure delivery, and practices that have optimized their procedure mix for office-based performance are capturing a reimbursement differential that their facility-dependent competitors are not. The site-of-service payment structure has always created financial distinctions between where procedures are performed. What is different in 2026 is the direction of that differential for specific procedure categories — and the operational implications for practices positioned to take advantage of it.