Glaucoma PhysicianCMS Proposal Would Affect Glaucoma Procedure Reimbursement

⚖️ Legal / Ethical Complexity

CMS has proposed payment changes that could affect common glaucoma workflows involving same-day evaluation and treatment. The proposal would reduce reimbursement for certain same-day E/M services while also lowering overall physician payment rates.

Professional Impact

• CMS would reimburse the higher-valued same-day service at 100% and additional services at 50%.
• Frequently performed glaucoma interventions, including SLT and laser peripheral iridotomy, could be affected.
• CMS projects 2027 conversion factors of $33.17 for qualifying APM participants and $32.84 for nonqualifying clinicians.
• Professional societies expressed concern that reimbursement changes could contribute to treatment delays and added operational burdens.

Action Items

• Review projected financial impact on same-day glaucoma treatment workflows.
• Monitor CMS rulemaking and final reimbursement decisions.
• Evaluate scheduling models involving same-day consultations and procedures.
• Submit comments or engage through professional society advocacy efforts.