Medicare Reimbursement for Fundus Photography (SPECTRALIS®)

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Topic: Fundus Photos

Sponsor: Heidelberg Engineering

Updated: 04/01/2025

This FAQ addresses the following:

What is fundus photography performed with Heidelberg Engineering’s SPECTRALIS®?
Is fundus photography covered by Medicare and other payers?
What CPT code is used to report fundus photography?
What documentation is required in the medical record to support a claim for fundus photography?
What is the reimbursement for 92250?
Is fundus photograph bundled with other tests or services?
What are Medicare’s super-vision requirements for fundus photography?
What is the frequency of fundus photography in the Medicare program?
How often may fundus photography be repeated?
If coverage for fundus photography is unlikely or uncertain, how should we proceed?

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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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