Reimbursement for Fundus and Autofluoresence Photography

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Topic: Fundus Photos

Sponsor: Canon

Updated: 02/18/2019

This FAQ addresses the following:

What is fundus photography performed with Canon’s retinal cameras?
What documentation is required in the medical record?
Does Medicare cover fundus and autofluorescence photography?
What CPT code describes 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 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?

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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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