Reimbursement for Fundus Photography

Topic: Fundus Photos

Sponsor: Heidelberg Engineering

Updated: 06/18/2024

Heidelberg Engineering

This FAQ addresses the following:

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