Valeda Light Therapy Coverage and Cost
Valeda Cost and Insurance
We know cost is one of the first questions patients ask about Valeda, and we would rather answer it plainly here than have you find out after you have committed to a course of treatment.
The short version: Retina Consultants San Diego accepts Medicare for patients who meet the FDA-authorized criteria for Valeda. If your treatment falls outside those criteria, you may choose to pay directly at the same rate Medicare currently reimburses. Payment is collected before treatment begins, and any sessions you pay for but do not receive are refunded to you.
The detail is below. If you would rather just talk it through, call us at 858-451-1911.
What Valeda Costs
Pricing is per treatment session and depends on whether one eye or both eyes are treated.
| Treatment | Per session | First year (27 sessions) |
|---|---|---|
| One eye (unilateral) | $190.00 | $5,130.00 |
| Both eyes (bilateral) | $285.00 | $7,695.00 |
These amounts reflect what Medicare currently reimburses for unilateral and bilateral Valeda treatment.
Two things to understand about the numbers.
First, payment is collected upfront, before your treatment begins, rather than session by session.
Second, 27 sessions covers your first year. Valeda is a two year program, consisting of an initial series of 9 sessions over three to five weeks followed by additional series every four months. Ask us what your full two year course is projected to cost before you begin, so you are planning against the real figure rather than the first year figure.
If You Have Medicare
RCSD accepts Medicare for Valeda when your treatment meets the FDA-authorized criteria for the device. Whether your treatment qualifies is a clinical determination made by your RCSD physician based on your exam and imaging, not something that can be decided over the phone. Our candidacy page explains the criteria in detail.
If your physician determines your treatment falls outside those criteria, Medicare is not expected to pay. You may still choose to proceed and pay directly, at the same rate Medicare reimburses.
You will be asked to sign an Advance Beneficiary Notice of Non-coverage (ABN) before treatment begins. This is a standard Medicare form. It confirms that you understand Medicare may not pay for the treatment and that you accept financial responsibility if it does not. Signing it does not commit you to treatment. It confirms you were told the situation in advance, which is exactly what we want.
If Medicare does pay a claim for your treatment, we reimburse you the amount collected on that claim for any sessions you did not use.
If You Have Commercial Insurance
Valeda is not currently a covered benefit under most commercial insurance plans. Where that is the case, we collect payment directly from you at the self-pay rate above.
If your commercial plan later pays a claim for your Valeda treatment, we reimburse you accordingly.
If You Stop Treatment, You Are Refunded for Sessions You Did Not Receive
This is the part we most want patients to understand, because committing to a full course is the thing that gives people pause.
You are refunded for any Valeda session you paid for and did not receive, regardless of the reason you stopped. You change your mind. Your health changes. You move. Life happens. Whatever the reason, you are only responsible for the sessions you actually had.
How it works:
- If you paid directly and discontinue before finishing, we refund the sessions not rendered. We retain payment only for sessions completed.
- If Medicare or your commercial plan pays a claim for your treatment, we reimburse you the amount collected on that claim for any unused sessions.
- Refunds are calculated by multiplying your remaining unused sessions by the applicable per session rate, whether that is the Medicare amount collected or the self-pay rate you paid, and are issued after treatment is discontinued.
You will sign a Payment and Reimbursement Acknowledgment before starting, which puts these terms in writing. There are two versions, one for Medicare beneficiaries and one for commercial insurance and self-pay patients. Our team will walk you through the one that applies to you.
Why Coverage Is Still Limited
Valeda received FDA marketing authorization in November 2024. Coverage for a newly authorized technology typically lags authorization while payers review the clinical evidence and establish their own policies.
This is ordinary for new treatments and it is not a statement about whether the therapy works. It does mean patients considering Valeda today are often making a direct pay decision, and we think you deserve to weigh that with complete information rather than partial information.
Talk to Us Directly
Cost should not be the reason you never find out whether Valeda could help you. Call our office at 858-451-1911 and we will go through the numbers for your specific situation before you make any decision.
If you have not yet been evaluated, start with what we look at and what rules Valeda out.