Contract intelligence
Structure payer products, fee schedules, Medicare tiebacks, and effective dates in one usable model.
Practice financial intelligence
Fulcrum for Optometry.
See how every contract, payment, and service line performs. See how exams, imaging, testing, and procedures perform across commercial and Medicare-linked contracts.
Financial visibility for Optometry
Exam and diagnostic revenue is easy to report, but hard to reconcile with contract terms.
Fulcrum structures payer rates and applies them to your actual optometry utilization, revealing likely underpayments and the services that contribute most to revenue.
One connected intelligence layer
Built for the questions your finance team actually has.
Payment monitoring
Detect and investigate potential underpayments in an automated, accurate way.
Forecasts & negotiations
Test proposed rates against actual volume and bring clear evidence into payer conversations.
Service-line economics
Integrate encounter and cost data to see precise unit economics for specific CPT codes.
What becomes answerable
Move from reported revenue to financial context.
- 01Which payer products are underperforming?
- 02Which payments do not match the contract?
- 03How will a proposed rate change affect revenue?
- 04Which services produce the strongest unit economics?
CY 2027 proposed PFS
What the proposed rule could mean for Optometry.
A national specialty average is useful context, not a practice forecast. Your result depends on your codes, volume, locality, sites of service, and Medicare-linked contracts.
-1.4%CMS specialty estimate
-2.1%Fulcrum reconstruction
CMS's projected overall impact for Optometry
CMS's own reconciliation table (Table D-B5) puts optometry at -1.4% for 2027. That figure is the specialty-wide, volume-weighted change in total RVU-based allowed charges: the aggregate gain or loss across every code the specialty bills, before the separate conversion-factor cut. Our reconstruction agrees closely at -2.1%, a net reduction of $31 million in national allowed charges.
Optometry bills about 98% of its Medicare dollars in the office (non-facility) setting, where nearly all of the change lands.
All figures are national, hold 2025 utilization fixed, and exclude the separate 1.68% conversion-factor cut that lands on every specialty on top of this.
The average hides the practice-level spread.
How Fulcrum models the PFS →
The specialty average hides a wide spread, and CMS's own practitioner-level file proves it. 37% of optometry practitioners land in the -1 to +1% band, and about 11% see a cut deeper than 2%. Where a practice lands is a question of service mix: the optometry practices hit hardest are those with the most office imaging and ophthalmic diagnostic testing.
Practice-specific analysis
See what your contracts and service mix say.
Start with one contract, one fee-schedule question, or an ongoing view across the practice.