Medicare Reimbursement for Fundus Photography with iCam

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Topic: Fundus Photos

Sponsor: Optovue

Updated: 01/28/2020

This FAQ addresses the following:

What is iCam?
What documentation is required in the medical record to support this test?
What CPT code should we use to describe this test with the iCam?
Does Medicare cover fundus photography?
What is the reimbursement for 92250?
Is fundus photography bundled with other tests or services?
Must the physician be present while the test is being performed?
How often may testing with the iCam be repeated?
What is the frequency of fundus photography in the Medicare program?
If coverage of 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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