June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Rates of Laser Trabeculoplasty by Ophthalmologists and Optometrists: A Comparative Analysis of the Center for Medicare & Medicaid Services Public Use File
Author Affiliations & Notes
  • Zain S Hussain
    University of Medicine and Health Sciences, Bassatere, Saint Kitts and Nevis
  • Lama A Al-Aswad
    NYU Langone Health, New York, New York, United States
  • Ben J. Harvey
    Dean McGee Eye Institute, Oklahoma City, Oklahoma, United States
  • Adegbenro Fakoya
    University of Medicine and Health Sciences, Bassatere, Saint Kitts and Nevis
  • Siamak Yousefi
    The University of Tennessee Health Science Center Department of Ophthalmology Hamilton Eye Institute, Memphis, Tennessee, United States
  • Footnotes
    Commercial Relationships   Zain Hussain None; Lama Al-Aswad Al Optics, Code C (Consultant/Contractor), Topcon Medical Systems Inc., Code C (Consultant/Contractor), Aerie Pharmaceuticals, Code C (Consultant/Contractor), Zeiss, Code C (Consultant/Contractor), GlobeChek, Code O (Owner), New World Medical Inc., Code R (Recipient), Save Vision Foundation, Code R (Recipient); Ben Harvey None; Adegbenro Fakoya None; Siamak Yousefi R21EY031725 , Code F (Financial Support), R01EY033005, Code F (Financial Support), National Eye Institute / National Institute of Health, Code R (Recipient), Bright Focus Foundation, Code R (Recipient), Research to Prevent Blindness, Code R (Recipient)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 2791 – A0121. doi:
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    • Get Citation

      Zain S Hussain, Lama A Al-Aswad, Ben J. Harvey, Adegbenro Fakoya, Siamak Yousefi; Rates of Laser Trabeculoplasty by Ophthalmologists and Optometrists: A Comparative Analysis of the Center for Medicare & Medicaid Services Public Use File. Invest. Ophthalmol. Vis. Sci. 2022;63(7):2791 – A0121.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To investigate utilization and payment of Laser Trabeculoplasty (LTP) performed by ophthalmologists and optometrists in three key US states based on CMS Public Use File.

Methods : We analyzed the Medicare Provider Utilization and Payment Data furnished by the CMS to identify LTP (CPT code 65855) claims in three key US states with optometric-expanded surgical authority in 2015 and 2018. We utilized regression, chi-square, and two-way t-tests to compare PUF metrics.

Results : The total sum of Medicare allowed payments to ophthalmologists and optometrists performing LTP amongst Fee-for-Service (FFS) Medicare beneficiaries in the US in 2018 was about 33% lower compared to 2015 while the total sum of Medicare Allowed payments in Kentucky (KY), Louisiana (LA), and Oklahoma (OK) in 2018 was about 26% lower compared to 2015. However, the optometric proportion of total Medicare allowed payments furnished by optometrists in three states increased from 11.3% to 17.9% between 2015 and 2018 (Fig. 1). Additionally, we observed significant increases in optometric-to-ophthalmologic average Medicare allowed payments between 2015 and 2018 in KY, LA, OK, and the tri-state cohort (all p<0.001) (Table 1). Significant optometric-to-ophthalmologic ratio increases in summed provider counts (p=0.007), summed unique Medicare beneficiary counts (p<0.001), and ultimately, summed service counts (p<0.001) were observed. Uniquely, we noticed that only one state amongst our tri-state cohort, LA, displayed non-significant differences in all three categories (p=0.91, p=0.35, p=0.29, respectively), despite significantly disproportionate changes in summed Medicare allowed LTP payments (p<0.001). Within the ophthalmologic cohort, female-to-male provider ratio significantly increased (p=0.008); however, the optometric cohort demonstrated no significant increases (p=0.99).

Conclusions : Optometric surgical authority is a continually expanding landscape throughout the United States. We investigated the latest edition of the CMS Medicare database to characterize LTP-associated metrics between ophthalmologists and optometrists in KY, LA, and OK states. Between 2015 and 2018, optometrists significantly increased their share of LTP-associated Medicare-allowed payments, unique beneficiary counts, service provider counts, and provider service counts.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

 

 

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