Medicare Reimbursement for Fundus Photography

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Topic: Fundus Photos

Sponsor: ZEISS

Updated: 05/29/2019

This FAQ addresses the following:

Does Medicare cover fundus photography using Carl Zeiss Meditec fundus instrumentation?
What documentation is required in the medical record?
How is fundus photography reimbursed?
Is fundus photography bundled with other tests or services?
Must the physician be present while the test is being performed?
How often may fundus photography be repeated?
What is the frequency of fundus photography in the Medicare program?
May I ever bill the Medicare beneficiary directly for this service?
Is there another separate CPT code for autofluorescence or red-free images?

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The reimbursement information is provided by Corcoran Consulting Group based on publicly available information from CMS, the AMA, and other sources. The reader is strongly encouraged to review federal and state laws, regulations, code sets, and official instructions promulgated by Medicare and other payers. This document is not an official source nor is it a complete guide on reimbursement. Although we believe this information is accurate at the time of publication, the reader is reminded that this information, including references and hyperlinks, changes over time, and may be incorrect at any time following publication.

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