On October 18, 2025, Sight Sciences announced that two Medicare Administrative Contractors—Novitas Solutions, Inc. and First Coast Service Options, Inc.—have each established jurisdiction‑wide fee schedules for CPT code 0563T, the code that covers the TearCare interventional dry‑eye procedure. The fee schedule is effective for service dates on or after January 1, 2025, and the established local fee amount is now active for claim processing and will be published on the MAC websites for provider reference.
The two MACs together cover an estimated 10.4 million Medicare fee‑for‑service beneficiaries, representing roughly 30% of the total Medicare fee‑for‑service population. By securing these fee schedules, Sight Sciences expands the reimbursement pathway for TearCare, potentially increasing the number of Medicare patients eligible for the procedure and creating a new revenue stream for the company. The company noted that it will provide updated revenue and adjusted operating‑expense guidance during its third‑quarter 2025 earnings call, reflecting the anticipated impact of the new fee schedule.
Sight Sciences also highlighted its Sight Access Portal, which offers providers assistance with patient benefit verification, prior authorizations, and reimbursement questions related to TearCare, OMNI, and SION. The announcement underscores the company’s ongoing efforts to secure payer coverage and streamline access for its interventional eye‑care technologies, positioning TearCare for broader adoption among Medicare beneficiaries.
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