Sight Sciences announced Medicare pricing for its TearCare procedure effective January 1, 2025, enhancing patient access.
Quiver AI Summary
Sight Sciences, Inc., an eyecare technology company, announced that two Medicare Administrative Contractors, Novitas Solutions and First Coast Service Options, have established jurisdiction-wide pricing for the procedure associated with its TearCare® System, aimed at treating meibomian gland dysfunction. Effective January 1, 2025, the CPT code 0563T pricing will apply in areas served by these contractors, which cover approximately 10.4 million Medicare beneficiaries. The company expressed gratitude for the support of eyecare providers and others in facilitating access to this treatment for patients deemed medically necessary. Additionally, Sight Sciences introduced the Sight Access Portal to assist healthcare providers with benefits verification and reimbursement queries, and it intends to update its financial guidance in its forthcoming earnings call.
Potential Positives
- Establishment of jurisdiction-wide pricing for the TearCare® System by two Medicare Administrative Contractors, enhancing reimbursement potential for the company's innovative products.
- Coverage of TearCare procedures for approximately 10.4 million Medicare beneficiaries, significantly expanding potential market access and patient reach.
- Positive acknowledgment from Medicare contractors following rigorous review process, reinforcing the credibility and value of the TearCare treatment within the eyecare community.
- Launch of the Sight Access Portal to assist providers with patient benefit verifications and reimbursement questions, which may improve provider satisfaction and streamline access to the company's products.
Potential Negatives
- Medicare coverage for the TearCare procedure is contingent on individual medical necessity determinations, potentially limiting access for patients who may need the treatment.
- The company did not provide specific updated revenue or operating expense guidance, which may raise concerns among investors regarding financial transparency and future performance.
- The need to engage with third-party payors and clinical societies suggests potential barriers to wider adoption and may imply current limitations in securing broader insurance coverage.
FAQ
What is the significance of the CPT code 0563T announcement?
The announcement establishes jurisdiction-wide pricing for the TearCare procedure, improving Medicare access for beneficiaries in specific regions.
Which Medicare Administrative Contractors are involved with TearCare pricing?
The involved MACs are Novitas Solutions, Inc. and First Coast Service Options, Inc.
When will the new Medicare fee schedule take effect?
The new fee schedule is effective for services on and after January 1, 2025.
How many covered lives are affected by this decision?
This decision impacts approximately 10.4 million Medicare beneficiaries across the covered states and regions.
What is the purpose of the Sight Access Portal?
The Sight Access Portal assists healthcare providers with patient benefit verifications, authorizations, and reimbursement inquiries for TearCare.
Disclaimer: This is an AI-generated summary of a press release distributed by GlobeNewswire. The model used to summarize this release may make mistakes. See the full release here.
$SGHT Insider Trading Activity
$SGHT insiders have traded $SGHT stock on the open market 20 times in the past 6 months. Of those trades, 9 have been purchases and 11 have been sales.
Here’s a breakdown of recent trading of $SGHT stock by insiders over the last 6 months:
- STAFFAN ENCRANTZ has made 9 purchases buying 317,496 shares for an estimated $1,210,121 and 0 sales.
- ALISON BAUERLEIN (Chief Financial Officer) has made 0 purchases and 3 sales selling 52,274 shares for an estimated $190,186.
- PAUL BADAWI (President and CEO) has made 0 purchases and 2 sales selling 48,078 shares for an estimated $179,773.
- JEREMY B. HAYDEN (Chief Legal Officer) has made 0 purchases and 2 sales selling 18,891 shares for an estimated $70,054.
- DAVID BADAWI (Chief Technology Officer) has made 0 purchases and 2 sales selling 11,712 shares for an estimated $43,432.
- MATTHEW LINK (Chief Commercial Officer) sold 4,889 shares for an estimated $20,035
- BRENTON TAYLOR (EVP, Operations & R&D) sold 591 shares for an estimated $1,991
To track insider transactions, check out Quiver Quantitative's insider trading dashboard.
$SGHT Hedge Fund Activity
We have seen 44 institutional investors add shares of $SGHT stock to their portfolio, and 30 decrease their positions in their most recent quarter.
Here are some of the largest recent moves:
- AMERICANA PARTNERS, LLC added 863,918 shares (+inf%) to their portfolio in Q2 2025, for an estimated $3,567,981
- MILLENNIUM MANAGEMENT LLC removed 629,352 shares (-92.0%) from their portfolio in Q2 2025, for an estimated $2,599,223
- BLACKROCK, INC. added 261,554 shares (+11.4%) to their portfolio in Q2 2025, for an estimated $1,080,218
- B. RILEY WEALTH ADVISORS, INC. removed 243,082 shares (-100.0%) from their portfolio in Q2 2025, for an estimated $1,003,928
- D. E. SHAW & CO., INC. removed 167,120 shares (-39.7%) from their portfolio in Q2 2025, for an estimated $690,205
- SQUAREPOINT OPS LLC removed 166,405 shares (-100.0%) from their portfolio in Q2 2025, for an estimated $687,252
- RENAISSANCE TECHNOLOGIES LLC removed 152,251 shares (-25.1%) from their portfolio in Q2 2025, for an estimated $628,796
To track hedge funds' stock portfolios, check out Quiver Quantitative's institutional holdings dashboard.
$SGHT Analyst Ratings
Wall Street analysts have issued reports on $SGHT in the last several months. We have seen 1 firms issue buy ratings on the stock, and 0 firms issue sell ratings.
Here are some recent analyst ratings:
- Lake Street issued a "Buy" rating on 08/08/2025
To track analyst ratings and price targets for $SGHT, check out Quiver Quantitative's $SGHT forecast page.
$SGHT Price Targets
Multiple analysts have issued price targets for $SGHT recently. We have seen 4 analysts offer price targets for $SGHT in the last 6 months, with a median target of $4.0.
Here are some recent targets:
- Joanne Wuensch from Citigroup set a target price of $4.0 on 10/07/2025
- Frank Takkinen from Lake Street set a target price of $5.0 on 08/08/2025
- Cecilia Furlong from Morgan Stanley set a target price of $4.0 on 07/15/2025
- Adam Maeder from Piper Sandler set a target price of $4.0 on 06/18/2025
Full Release
MENLO PARK, Calif., Oct. 17, 2025 (GLOBE NEWSWIRE) -- Sight Sciences , Inc. (Nasdaq: SGHT) (Sight Sciences or the Company), an eyecare technology company focused on developing and commercializing innovative, interventional technologies intended to transform care and improve patients’ lives, today announced that two Medicare Administrative Contractors (MACs), Novitas Solutions, Inc. (Novitas) and First Coast Service Options, Inc. (FCSO), each established jurisdiction-wide pricing for CPT ® code 0563T (evacuation of meibomian glands, using heat delivered through wearable, open-eye eyelid treatment devices and manual expression, bilateral), which describes the procedure performed with the Company’s TearCare ® System and related accessories (TearCare). The Medicare fee schedule amount is effective for dates of service on and after January 1, 2025, in all Novitas and FCSO jurisdictions and localities.
The established local fee schedule amount for CPT code 0563T is active for claim processing and is expected to be published on the Novitas and FCSO websites for reference by eyecare providers in these areas. TearCare procedure claims will be payable by First Coast and Novitas in the areas administered by them based on individual medical necessity determinations.
The states and regions covered by these two MACS have 10.4 million in estimated total covered lives and represents approximately 30% of the total Medicare fee-for-service covered lives 1 .
MAC
|
States / Regions Covered | Estimated Covered Lives 1 |
Novitas Solutions, Inc. | Arkansas, Colorado, District of Colombia, Delaware, Louisiana, Maryland, Mississippi, New Jersey, New Mexico, Oklahoma, Pennsylvania, and Texas | 8.0 million |
First Coast Service Options, Inc. | Florida, Puerto Rico, Virgin Islands | 2.4 million |
“We are pleased that the rigorous TearCare review conducted by Novitas and First Coast Service Options resulted in established pricing for TearCare. We want to thank our eyecare providers, national and state societies, and Novitas and First Coast Service Options for their work to allow access to this important interventional dry eye treatment for Medicare beneficiaries in these areas when deemed medically necessary by their eyecare provider,” said Paul Badawi, Co-Founder and Chief Executive Officer of Sight Sciences. “We plan to continue to engage with third-party payors, clinical societies, and other stakeholders in continued support of patient access for the TearCare procedure.”
Sight Sciences recently launched the Sight Access Portal, which is available to provide assistance to all TearCare ® System, OMNI ® Surgical System, and SION ® Surgical Instrument providers with patient benefit verifications, assistance with prior authorizations, predeterminations, and any reimbursement questions.
2025 Financial Guidance
The Company plans to provide updated revenue and adjusted operating expenses guidance during its third quarter 2025 earnings call, taking into account the factors discussed in this press release.
1 Covered lives estimate is derived from publicly available information and includes Medicare fee for service and Medicare fee for service - Medicaid Dual-Eligible beneficiaries.
About Sight Sciences
Sight Sciences is an eyecare technology company focused on developing and commercializing innovative and interventional solutions intended to transform care and improve patients’ lives. Using minimally invasive or non-invasive approaches to target the underlying causes of the world’s most prevalent eye diseases, Sight Sciences seeks to create more effective treatment paradigms that enhance patient care and supplant conventional outdated approaches. The Company’s OMNI ® Surgical System and OMNI ® Edge Surgical System are implant-free, minimally invasive glaucoma surgery technologies indicated in the United States to reduce intraocular pressure in adult patients with primary open-angle glaucoma. The OMNI Surgical System is CE Marked for the catheterization and transluminal viscodilation of Schlemm’s canal and cutting of the trabecular meshwork to reduce intraocular pressure in adult patients with open-angle glaucoma. Glaucoma is the world’s leading cause of irreversible blindness. The SION ® Surgical System is a bladeless, manually operated device used in ophthalmic surgical procedures to excise trabecular meshwork. The Company’s TearCare ® System is 510(k) cleared in the United States for the application of localized heat therapy in adult patients with evaporative dry eye disease due to meibomian gland disease (MGD), enabling clearance of gland obstructions by physicians to address the leading cause of dry eye disease.
Visit www.sightsciences.com for more information.
Sight Sciences and TearCare are trademarks of Sight Sciences registered in the United States. OMNI and SION are trademarks of Sight Sciences registered in the United States, European Union and other territories.
CPT is a registered trademark of the American Medical Association.
© 2025 Sight Sciences. All rights reserved.
Forward-Looking Statements
This press release, together with other statements and information publicly disseminated by the Company, contains certain forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. The Company intends such forward-looking statements to be covered by the safe harbor provisions for forward-looking statements contained in the Private Securities Litigation Reform Act of 1995 and includes this statement for purposes of complying with these safe harbor provisions. Any statements made in this press release that are not statements of historical fact, including statements about our beliefs and expectations, are forward-looking statements and should be evaluated as such. These statements often include words such as “anticipate,” “expect,” “suggests,” “plan,” “believe,” “intend,” “estimates,” “targets,” “projects,” “should,” “could,” “would,” “may,” “will,” “forecast” and other similar expressions. We base these forward-looking statements on our current expectations, plans and assumptions that we have made in light of our experience in the industry, as well as our perceptions of historical trends, current conditions, expected future developments and other factors we believe are appropriate under the circumstances at such time. Although we believe that these forward-looking statements are based on reasonable assumptions at the time they are made, you should be aware that many factors could affect our business, results of operations and financial condition and could cause actual results to differ materially from those expressed in the forward-looking statements. These statements are not guarantees of future performance or results. These forward-looking statements include, but are not limited to, statements concerning the following: the effective date of the MAC fee schedules; the basis for payment of procedures billed under CPT 0563T; the publication of the MAC fee schedule amount on MAC websites; MAC payment for TearCare procedures based on individual medical necessity determinations; the Company’s intent to continue to engage with third-party payors, clinical societies, and other stakeholders regarding patient access for the TearCare procedure; and the Company’s plan to provide updated revenue and adjusted operating expenses guidance during its third quarter 2025 earnings call. These forward-looking statements are subject to and involve numerous risks, uncertainties and assumptions, including those discussed under the caption “Risk Factors” in our filings with the U.S. Securities and Exchange Commission, as may be updated from time to time in subsequent filings, and you should not place undue reliance on these statements. These cautionary statements are made only as of the date of this press release. We undertake no obligation to update or revise any forward-looking statements, whether as a result of new information, future events or otherwise, except as required by applicable law.
Media contact:
[email protected]
Investor contact:
Philip Taylor
Gilmartin Group
415.937.5406
[email protected]