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Medicare reimbursement rates for glaucoma procedures on the decline

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Tell me about the research. 

Investigators compiled CPT reimbursement codes for 22 glaucoma procedures between 2000 and 2020 from the US Centers for Medicare and Medicaid (CMS) physician fee schedule database.

What exactly did they find?

The investigators discovered that the average reimbursement rate for the studied procedures declined by 20.5%, with the greatest cut seen in laser trabeculoplasty (48.9%), iridotomy (37%), and cyclophotocoagulation (32.4%). (via)

Were there any increased reimbursements?

Just one. The CPT code for iridoplasty-photocoagulation had a 1.9% increase. 

Any limitations to the study?

The study authors noted that the volume of procedures performed and time spent per each procedure was not tracked—major information that could be relevant in the reasoning behind the reimbursement cuts. 

What’s the significance of these findings?

A reduction in Medicare payments for glaucoma procedures might have ongoing implications for practice management strategies, including encouraging ophthalmologists to continue to diversify their practice offerings.

What can be done?

Study authors concluded that physician groups placing more pressure on CMS and Congress could potentially prevent further reimbursement cuts.