Perspectives on Medicare’s Proposed iDose TR Coverage Policy

In May 2026, 5 Medicare Administrative Contractors released proposed Local Coverage Determinations (LCDs) addressing Medicare reimbursement for anterior-segment intraocular nonbiodegradable drug-eluting systems, a category that currently includes only the travoprost intracameral implant iDose TR (Glaukos). Many glaucoma specialists believe the proposed LCDs do not reflect contemporary glaucoma practice or the clinical rationale underlying sustained drug-delivery therapies. Glaucoma Physician spoke with several leading surgeons about the proposed LCDs, the reasons for their concerns, and the changes they believe would better reflect contemporary glaucoma practice.

By
Steven R. Sarkisian, Jr., MD
Inder Paul Singh, MD
Savak “Sev” Teymoorian, MD, MBA
Manjool Shah, MD
Christine Funke, MD
Philip S. Garza, MD, MSc
September 1, 2026
10 min

Glaucoma Physician

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Medicare's proposed LCDs for iDose TR require patients to fail medical management and selective laser trabeculoplasty before implantation.
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The proposed LCDs prohibit concurrent implantation of iDose TR with other ophthalmic surgeries, except cataract surgery.
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Many glaucoma specialists argue that the proposed LCDs do not align with contemporary glaucoma practices or the role of sustained drug delivery.
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Physicians express concern that the proposed policies restrict patient access and do not consider individual treatment needs.
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Experts emphasize the importance of following FDA recommendations for procedural pharmaceuticals to ensure evidence-based care.

Perspectives on Medicare’s Proposed iDose TR Coverage Policy

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Original Source(s)

Perspectives on Medicare’s Proposed iDose TR Coverage Policy

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