United States Medicare Reimbursement Trends for Glaucoma Procedures: 2000–2020

Abstract

Purpose: The purpose of this study is to investigate US Medicare reimbursement trends for common glaucoma procedures from 2000 to 2020. Materials and Methods: Current Procedural Terminology codes for Glaucoma procedures in the US centers for Medicare and Medicaid Services database were used to conduct this economic analysis. Reimbursement data from the Physician Fee Schedule look-up tool from the Centers for Medicare and Medicaid Services were compiled for the selected procedures and compensation trends were investigated after adjusting for inflation in 2020 US dollars from the unadjusted data between 2000 and 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 20-year period. On average, there was a 1.03% decrease in reimbursement rates per year (95% CI, −0.74% to −1.33%), with an adjusted compound annual growth rate of −1.35% (95% CI, −1.07% to −1.64%). The results show an overall declining rate in reimbursement for the glaucoma procedures analyzed in this study. Conclusions: The US Medicare reimbursement for glaucoma procedures in the United States showed a significant decline between 2000 and 2020. These findings may be relevant to understanding changing practice patterns for glaucoma care.

Trends in Medicare Reimbursements for Commonly Performed Laryngeal Procedures from 2000 to 2021

“…As such, the objective of this study is to investigate Medicare reimbursement trends for commonly performed laryngeal procedures. Inflation-adjusted declines in reimbursement have been found not only in neurosurgery, 4 general surgery, 5 orthopedic surgery, 6 reconstructive plastic surgery, 7 ophthalmology, 21,22 and interventional radiology 23 but also in otolaryngology 9 and its subspecialties. 10,11,24 This study found a 20.3% inflation-adjusted decline in reimbursement of laryngeal procedures.…”

Glaucoma Surgery Shifts Among Medicare Beneficiaries After 2022 Reimbursement Changes in the United States

“…Despite well-documented evidence of increased procedural demand year over year across ophthalmology procedures, reimbursement has persistently declined. 9,[13][14][15] Business management groups for ophthalmology practices, ambulatory surgery centers, and hospitals heavily weigh costs, time management, and logistics to maintain sound financial positions. Furthermore, inadequate reimbursements can deter physician surgical utilization by making procedures financially unfeasible, as the investment of time required for patient counseling, surgical procedures, and potential complication management remains unchanged.…”

“…Medicare reimbursement, largely dictated by CMS, remains an area of concern among ophthalmologists, especially in the context of recent and significant Medicare Physician Fee Schedule Final Rule cuts in 2022 and 2023. Despite well-documented evidence of increased procedural demand year over year across ophthalmology procedures, reimbursement has persistently declined 9,13–15 . Business management groups for ophthalmology practices, ambulatory surgery centers, and hospitals heavily weigh costs, time management, and logistics to maintain sound financial positions.…”