Lipiflow

Lipiflow is a FDA-cleared medical device that treats meibomian gland dysfunction by applying controlled heat and pressure to the eyelids. Most major insurance providers, such as Aetna and UnitedHealthcare, classify Lipiflow as investigational or not medically necessary, which typically results in no coverage, according to YourInsuranceInfo.

CPT code 0207T specifically identifies Lipiflow treatment for billing purposes. Out-of-pocket costs for Lipiflow average $700–$1,000 per session in 2024 US clinics.

Medicare does not reimburse for Lipiflow procedures according to their published coverage policies. Insurance pre-authorization for Lipiflow is usually denied because insurers consider it experimental.

Eye care clinics often require full payment at the time of service since carriers like Blue Cross Blue Shield routinely exclude this procedure from benefits lists. FSA (Flexible Spending Account) or HSA (Health Savings Account) funds may be used for Lipiflow only with a physician’s prescription confirming medical necessity.

Patients sometimes receive partial reimbursement through employer wellness plans if supported by documentation, as seen in cases reported by MetLife benefit holders. No current state Medicaid plan covers Lipiflow under routine vision or ophthalmology benefits as verified by review of state provider manuals in 2023.