I 
115TH CONGRESS 
2D SESSION 
H. R. 6639 
To amend title XVIII of the Social Security Act to provide for coverage 
under the Medicare program of digital retinal imaging with remote inter-
pretation. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 27, 2018 
Mr. REED (for himself and Ms. SEWELL of Alabama) introduced the following 
bill; which was referred to the Committee on Energy and Commerce, and 
in addition to the Committee on Ways and Means, for a period to be sub-
sequently determined by the Speaker, in each case for consideration of 
such provisions as fall within the jurisdiction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to provide 
for coverage under the Medicare program of digital ret-
inal imaging with remote interpretation. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Diabetic Vision Loss 
and Blindness Prevention Act of 2018’’. 
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SEC. 2. MEDICARE COVERAGE OF DIGITAL RETINAL IMAG-
ING WITH REMOTE INTERPRETATION. 
(a) COVERAGE.—Section 1861 of the Social Security 
Act (42 U.S.C. 1395x) is amended— 
(1) in subsection (s)(2)— 
(A) in subparagraph (FF), by striking 
‘‘and’’ at the end; 
(B) in subparagraph (GG), by adding 
‘‘and’’ at the end; and 
(C) by inserting after subparagraph (GG) 
the following new subparagraph: 
‘‘(HH) digital retinal imaging with remote 
interpretation (as defined in subsection (jjj));’’; 
and 
(2) by adding at the end the following new sub-
section: 
‘‘(jjj) DIGITAL RETINAL IMAGING WITH REMOTE IN-
TERPRETATION.—The term ‘digital retinal imaging with 
remote interpretation’ means an exam for the purpose of 
early detection or assessment of diabetic retinopathy 
that— 
‘‘(1) is provided not more frequently than on an 
annual basis to an individual who has been diag-
nosed with diabetes and who— 
‘‘(A) does not have prior known diabetic 
retinopathy; or 
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‘‘(B) is not known to have worse than mild 
non-proliferative diabetic retinopathy (ETDRS 
level 35); 
‘‘(2) is provided by or under the supervision of 
a primary care practitioner (as defined in section 
1833(x)) or board-certified endocrinologist; 
‘‘(3) utilizes a retinal camera with optical reso-
lution compliant with the International Organization 
for Standardization ISO 10940 to take digital im-
ages of structures behind the lens of the eye, such 
as the retina, choroid and optic nerve; and 
‘‘(4) involves the electronic transmission of such 
images for evaluation for diabetic retinopathy and 
other diseases of the eye by a board-certified, State- 
licensed ophthalmologist.’’. 
(b) PAYMENT.—Notwithstanding section 1834(m) of 
the Social Security Act (42 U.S.C. 1395m(m))— 
(1) payment shall be made pursuant to the 
amendments made by subsection (a) for digital ret-
inal imaging with remote interpretation under CPT 
code 92250; and 
(2) the Secretary of Health and Human Serv-
ices shall establish a national minimum payment 
amount for CPT code 92250 and any successor to 
such codes that is not less than the reimbursement 
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rate in effect for such code (or predecessor code) on 
December 31, 2017. 
Æ 
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