Key Takeaways

• CMS assigned a $1,000 supply valuation to TearCare SmartLids under new code SD397, effective January 1, 2027

• The disposable component is used in thermal adaptive gland procedures for MGD reported under CPT code 0563T

The Centers for Medicare & Medicaid Services (CMS) has established a new direct practice expense supply code for the single-use TearCare SmartLids component of Sight Sciences’ TearCare System, assigning a value of $1,000 effective January 1, 2027.

The new code, SD397, was included in the calendar year 2027 Medicare Physician Fee Schedule Final Rule. The designation provides a nationally recognized valuation for the disposable component used in TearCare procedures to treat meibomian gland dysfunction (MGD).

CMS maintains a database of direct practice expense items and associated values to document the resources and costs involved in procedures reported under Current Procedural Terminology (CPT) codes.

“Establishing a validated, nationally recognized supply valuation for TearCare provides greater transparency into an important direct practice expense associated with the procedure,” said Paul Badawi, co-founder and CEO of Sight Sciences. “We appreciate CMS’ decision which we believe can support more transparent and consistent reimbursement for TearCare procedures over time.”

TearCare SmartLids adhere to the tarsal plates of the upper and lower eyelids and deliver software-controlled therapeutic heat to soften meibomian gland obstructions while allowing patients to blink during treatment.

The devices are used in the thermal adaptive gland procedure described by CPT code 0563T, which involves bilateral evacuation of the meibomian glands using heat delivered through wearable, open-eye eyelid devices, followed by manual gland expression.

The new supply code does not establish a national Medicare payment rate or separate reimbursement for SmartLids. CPT code 0563T remains carrier-priced, with payment decisions subject to individual payer coverage and reimbursement policies.