CPT 92229 (AI Diabetic Retinopathy Screening) — $50 Medicare + $100 Commercial in 2026, Highest-Margin Vision Code for FQHCs Without an OD

AAO EyeNet's 2026 update confirms CPT 92229 (point-of-care autonomous AI diabetic-retinopathy screening) is fully reimbursable across Medicare, Medicaid, and private insurance. Medicare national average ~$50 for 2026; private payers frequently reimburse up to $100 per exam.

CA Medi-Cal optometry baseline remains ~$47/comprehensive exam (unchanged in 25 years per COA), making 92229 the highest-margin vision service an FQHC primary care site can bill without an optometrist on staff. Strategic implication for the 70%+ of CA FQHCs without on-site optometry: CPT 92229 is the single billable vision code their primary care MAs/RNs can execute today (camera + autonomous AI, no OD interpretation required).

At $50 Medicare / $100 commercial vs. ~$47 Medi-Cal OD exam, it is unique in the vision benefit as a service where AI-augmented primary care out-earns the existing OD fee schedule. Strengthens the AI-DR screening business case during the SB 776 / AB 407 implementation window.