OBJECTIVES: We sought to analyze time to follow-up, sequence of treatment, cost, and mortality in non-small cell lung cancer (NSCLC) patients treated with photodynamic therapy (PDT) or non-PDT ablation therapy. METHODS:  Retrospective cohort analysis using SEER-Medicare linked data. Patients with NSCLC diagnosed between 2000 and 2011were identified and retrospectively followed for one-year pre and up to ten-year post diagnosis. We analyzed the proportion of treatment that occurred during phases of care and sequence of PDT treatment. Primary outcome was time to follow-up surgery or radiation therapy, after PDT or non-PDT ablation therapy. Time to treatment, variation in health service use and cost were compared between PDT and non-PDT ablation groups using GLM, Poisson (Zero inflated), and GLM-log link models respectively. Propensity score approach was used to minimize selection bias. RESULTS: Of the NSCLC cohort of 359,608, 136 patients received PDT with other treatments, and 1405 received non-PDT ablation with other treatments. In PDT group, 66% and in non-PDT ablation group, 75% of the treatment was within one-year of NSCLC diagnosis. Unadjusted mean time to follow-up treatment was 235 days (SD 566) for PDT group and 147 days (SD 382) for non-PDT ablation group. After adjusting for demographic and clinical characteristics, PDT group was associated with an average increase of 80 days in time to follow-up treatment (p=0.0253) compared to non-PDT ablation group. Compared to radiation alone, PDT group showed decreased hazard of overall five year mortality (HR= 0.64, CI= 0.53, 0.77). PDT was associated with 38% increase in cost, compared to non-PDT ablation group (p=0.0014). CONCLUSIONS: PDT was associated with longer time to follow-up treatment compared to non-PDT ablation in patients with NSCLC. Currently, PDT is offered in various combinations with surgery and radiation. This demands further research to investigate the efficacy and effectiveness of these combinations in larger studies.