Abstract
Purpose :
Medicare reimbursements for glaucoma procedures have declined on average by 21% since the year 2000. These trends can help guide changes to Medicare policies and may explain the change in glaucoma practice patterns over time.
Methods :
Reimbursement data from the Physician Fee Schedule look-up tool from the Centers for Medicare and Medicaid Services was compiled for Glaucoma procedures. Compensation trends for each CPT code were investigated after adjusting for inflation in 2020 US dollars from the unadjusted data between 2000 to 2020.
Results :
The average adjusted reimbursement for the analyzed procedures decreased by 20.5% (95% confidence interval [CI], -15.4% to -25.6%) over the twenty-year period. On average, there was a 1.03% decrease in reimbursement rates per year (95% confidence interval [CI], -0.74% to -1.33%) with an adjusted CAGR of -1.35% (95% confidence interval [CI], -1.07% to -1.64%). Procedures with the largest decrease in reimbursement over the study period included CPT codes 65855 (Trabeculoplasty by laser surgery, 48.9%), 66761 (Iridotomy/iridectomy by laser surgery, 37.0%), and 66700 (Destruction ciliary body by diathermy, 32.37%). The only CPT code for which an increase in reimbursement rate was observed was 66762 (Laser iridoplasty by photocoagulation, 1.89%). These results show an overall declining rate in reimbursement for the glaucoma procedures analyzed in this study.
Conclusions :
Medicare reimbursement for glaucoma procedures showed a significantly declining trend between 2000 to 2020. The varying trends seem to closely reflect the political and economic climate of the times. The declining trends previously led to some physicians refusing to take new Medicare patients. However, the legislative impact of the Consolidated Appropriations Act of 2020 brings hope for a future of rising Medicare reimbursement rates for Ophthalmology, and other medical specialties.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.