Medicare Payments for Glaucoma Care from 2019 to 2024

Abstract Background Medicare is a publicly funded insurer in the United States that distributes payments for patient health care. This report reviews Medicare payments for glaucoma-related care from 2019 to 2024. The purpose of this article is to increase understanding of Medicare payments by identifying trends over a recent 5-year period. Methods Data were obtained from the Centers for Medicare & Medicaid Services. Billing codes related to glaucoma diagnosis and management were identified and their corresponding payment amounts from Medicare were documented. Medicare payments for diagnostic testing, clinical exams, procedures, and medications were formatted into Tables and payment values across study years were compared. Results This study contains the Medicare payment details from 2019 and 2024 for five diagnostic testing codes, 13 clinical exam codes, eight procedural codes, and 25 drug products. There were differences in the payment amount based on whether the site of service was in facility or in office. Payment for all diagnostic testing codes decreased from 2019 to 2024 in each setting. Payment decreased for seven clinical exam codes in each setting. Payment increased for six clinical exam codes in facility and five clinical exam codes in office. Payment increased for five procedures in facility and four procedures in office. The payment for one procedural code decreased in both settings. Spending per dose increased for 15 drug products from 2019 to 2024. Conclusions Our study aims to recognize the changes in average Medicare payments for glaucoma-related care from 2019 to 2024. Our findings indicate there was a decrease in Medicare payment amounts for all diagnostic testing codes and most clinical exam codes, while there was an increase in Medicare payment for most procedural codes and an increase in spending for glaucoma medications. Although prices were listed and compared in nominal dollars as reported by CMS, adjusting for inflation would likely widen these differences.