Opening an Ophthalmology Practice: Licensing, Space & Requirements

Launching an Ophthalmology Practice: Comprehensive Checklist

1. Licensing & Credentialing

• State medical license (MD/DO)
• Board certification / eligibility (ABO)
• DEA registration, CDS license
• NPI, Medicare/Medicaid enrollment, CAQH
• Malpractice insurance (occurrence vs. claims-made)

2. Location & Space (2,500–5,000+ sq ft)

• High visibility, accessibility, parking, ADA compliance
• Zoning: Medical office / commercial
• Layout: Reception, waiting, pre-test, 3+ exam lanes, specialty testing room, minor procedure/laser suite, optical dispensary, admin, staff lounge, sterile storage.
• Build-out: Slit-lamp beams, compressed air/vac, dedicated circuits, data drops, lead-lined walls if laser.

3. Core Equipment (Capital: $300k–$1M+)

• Slit lamps (2+), tonometers (GAT, NCT), autorefractor/keratometer, lensometer
• OCT (retina/glaucoma), visual field analyzer, fundus camera, topography
• YAG/SLT laser, argon/diode laser, phacoemulsification system (if surgical)
• Surgical microscope, vitrectomy machine (if retina)
• EMR/EHR with ophthalmology templates, imaging integration

4. Staffing

• Ophthalmic technicians (COA/COMT/COMT)
• Opticians (optical)
• Scribes, front desk, billing/coding, practice manager
• Optometrist (co-management, overflow)
• ASC staff if surgical suite

5. Regulatory Compliance

• HIPAA (privacy/security risk analysis, BAA)
• OSHA (bloodborne pathogens, laser safety, hazard comm)
• CLIA (if lab testing)
• Stark/Anti-Kickback (referral relationships)
• State health department, fire marshal, controlled substance

6. Financial Planning

• Pro forma: startup $500k–$2M; breakeven 12–24 mo
• Payer mix analysis, fee schedule negotiation
• Revenue cycle management (RCM) strategy

Engage a healthcare attorney, practice consultant, and architect early.