Here is a service that barely existed in community pharmacy two years ago, that McKesson just piloted at ideaShare 2026, and that carries a live CPT code, active Medicare reimbursement, and a market growing at 21% annually. Most pharmacists reading this newsletter have never heard of it.
AI-powered diabetic retinopathy screening in the pharmacy setting is here. And the business case is almost unreasonably strong.
The Clinical Problem That Created This Opportunity
Diabetic retinopathy stands as the leading cause of new-onset blindness among adults aged 20 to 74 years. Current guidelines by the American Academy of Ophthalmology recommend that patients diagnosed with diabetes undergo yearly screenings for detection of referable cases. Despite this recommendation, over half of diabetic patients forgo their annual dilated eye exams, escalating undiagnosed disease risks and preventable vision loss.
The patient most at risk is the one already standing in front of you. The diabetic patient who skips ophthalmology appointments but refills their metformin every month at your counter. The one who manages their A1c and their blood pressure but has not seen an ophthalmologist in three years. That patient has a condition that, if undiagnosed, can progress silently to irreversible vision loss, but can be caught and treated if identified early. No pharmacy has historically been positioned to close that gap. That positioning is changing right now.
The Technology That Makes This a Pharmacy Service
The historical barrier to retinopathy screening outside a specialty clinic was the requirement for an on-site ophthalmologist or trained reader to interpret retinal images. AI eliminates that requirement entirely.
Three currently FDA-cleared autonomous AI systems exist for diabetic retinopathy testing: LumineticsCore, EyeArt, and AEYE Diagnostic Screening. These systems analyze retinal fundus photographs in real time and produce an autonomous point-of-care result without requiring an on-site ophthalmologist.
LumineticsCore was the first autonomous AI testing system to secure Medicare and Medicaid reimbursement and qualify for HEDIS care gap closure and Merit-based Incentive Payment System care gap closure.
The CPT code infrastructure followed the technology, and it arrived faster than almost any other AI clinical service.
In September 2020, the American Medical Association Current Procedural Terminology Editorial Panel created code 92229 for retinal imaging with autonomous point-of-care interpretation. This was the first CPT code for autonomous AI in any specialty.
In the fall of 2021, the Centers for Medicare and Medicaid Services approved CPT 92229 specifically for autonomous AI devices for detecting disease. The description: “imaging of retina for detection or monitoring of disease; point-of-care autonomous analysis and report, unilateral or bilateral.” As of 2022, the nonfacility outpatient reimbursement amount according to the Medicare Physician Fee Schedule was $45.75 per encounter.
The billing infrastructure exists. The reimbursement pathway exists. What hasn’t existed until now is the community pharmacy pilot to prove the model is operationally viable in a non-clinical setting.
McKesson just launched it.
What McKesson Announced at ideaShare
Niki Shah, MHSA, MBA, CCHW, vice president of Health Impact and Innovation at McKesson, detailed the new diabetic retinopathy screening pilot in an interview with Pharmacy Times at ideaShare 2026: “We’re also partnering with the American Pharmacy Association Foundation and the American Academy of Ophthalmology to place an AI-enabled technology that would actually do the screening in the pharmacy setting, embedded in the clinical experience that patients are already having. What’s unique about this is that the patient will receive the result while they’re there in the pharmacy, and the pharmacist will have the ability to make the appropriate coordinated referral or follow-up and next steps that are needed while the patient is there. So we believe that this will help with early detection of diseases, that it will increase more access points, and that it will improve health outcomes for patients overall.”
Three things make this McKesson pilot structurally different from prior retinopathy screening initiatives that have tried and stalled in primary care settings.
First, the result is delivered in real time while the patient is still at the pharmacy, not mailed to them later, not routed to a portal they may or may not check. The pharmacist receives the result, counsels the patient on its meaning, and coordinates the next step, whether that is a referral to ophthalmology, a confirmation that no referable disease was found, or patient education on the importance of follow-up monitoring.
Second, the integration is embedded in the clinical experience patients are already having at the pharmacy. Not a separate appointment. Not a separate facility. A service that happens in the context of the medication fill visit, the blood pressure check, or the A1c point-of-care test that the patient was already there for.
Third, the partnership with the APhA Foundation and the American Academy of Ophthalmology brings both professional credibility and outcome data collection infrastructure to the pilot. This is not an unvalidated service model. It is a structured pilot designed to generate publishable evidence about feasibility, patient acceptance, and pharmacist implementation capacity.
The Market Trajectory Behind the Timing
The broader AI-enabled diabetic retinopathy screening market confirms that this service category is moving from early adoption to rapid expansion regardless of whether any individual pharmacy acts on it.
Based on claims database data from 2023, diabetic retinopathy testing has become one of the most widely adopted and fastest-growing AI-aided medical procedures in the United States, second only to coronary artery disease imaging.
The market projection makes the pharmacy entry timing genuinely strategic. The U.S. AI-driven diabetic retinopathy screening market is predicted to grow from approximately $231 million in 2026 to approximately $1.3 billion by 2035, expanding at a compound annual growth rate exceeding 21%. This is not a saturated category with established dominant players in every geography. It is a category being built right now, and the pharmacies that operationalize it at scale while the market is still forming will have years of first-mover advantage before competitors arrive.
The Real-World Implementation Data from Health System Pilots
The pharmacy pilot builds on a body of evidence from health system implementations that established the clinical and operational parameters. Understanding those precedents matters for pharmacists evaluating whether this service is realistic to run.
AI-aided diabetic retinopathy testing programs at academic health systems have demonstrated several consistent lessons about successful implementation. Programs that integrated screening into existing workflows, particularly diabetes care visits and primary care appointments, achieved higher uptake than those requiring separate appointments. Patient acceptance rates were high when the service was introduced by the clinician they already trusted. Same-day result delivery improved patient engagement with referral recommendations versus asynchronous result delivery. Staff training on device operation was brief and did not require extensive clinical background.
The American Diabetes Association 2022 Standards of Medical Care in Diabetes noted that autonomous AI systems for diabetic retinopathy screening can be used as an alternative to traditional dilated eye exams in adults with type 2 diabetes. This guideline endorsement, combined with HEDIS measure alignment and CPT code availability, positions diabetic retinopathy screening as one of the most comprehensively supported point-of-care services a pharmacy could add.
The specific patient population parameters: AI-based screening is validated for adult patients with diabetes type 1 or type 2. Contraindications include known advanced retinopathy already under active ophthalmology care, in which case referral is the appropriate action rather than screening. The service is specifically designed for the unscreened or under-screened patient, which describes the majority of diabetic patients in a typical independent pharmacy panel.
The Billing and Quality Architecture
The CPT 92229 reimbursement picture requires understanding both the Medicare fee schedule value and the quality measure alignment that creates additional financial incentive.
At $45.75 per encounter under the 2023 Medicare fee schedule, the direct reimbursement per screen is modest. A pharmacy screening 10 eligible Medicare patients per week generates approximately $450 weekly, or roughly $23,000 annually, from direct billing alone. The more substantial financial argument is the quality measure alignment.
LumineticsCore’s qualification for HEDIS care gap closure and MIPS care gap closure means that pharmacies operating within accountable care organization or value-based care arrangements generate quality metric credit for each completed diabetic retinopathy screen. For pharmacies enrolled in Stars performance programs or ACO quality reporting, that credit can translate into shared savings or performance bonuses that dwarf the direct CPT billing revenue.
The HEDIS alignment is also the lever that makes prescriber partnership valuable. A primary care practice or endocrinology group with quality performance metrics tied to diabetic retinopathy screening completion rates has a direct financial incentive to refer their unscreened patients to a pharmacy partner who can close that gap during a routine medication fill visit. The pharmacy becomes a care gap closure partner, not just a pharmacy service.
Your Action This Week
Two parallel actions, both of which can be completed before Friday.
McKesson has partnered with the American Pharmacists Association Foundation and the American Academy of Ophthalmology to embed AI-enabled technology in community pharmacies. The pilot is actively selecting participating pharmacies now. Contact the APhA Foundation directly at pharmacist.com to express interest in the diabetic retinopathy screening pilot program. Even if you miss the initial cohort, getting on the program team’s radar positions you for the next wave of expansion.
In parallel, look up CPT code 92229 and pull your payer mix’s reimbursement rates for it. Contact your top three payers and ask directly whether they reimburse 92229 and under what clinical and credentialing conditions. Then ask whether their quality programs have care gap measures tied to diabetic retinopathy screening completion, and what documentation they require to count a pharmacy-performed screen toward those measures.
The pharmacies that understand the billing and quality infrastructure before they acquire the device are the ones that build a profitable, integrated service line from day one. The ones that buy the device first and figure out the billing second spend the first year solving problems that pre-acquisition research would have prevented.
The CPT code exists. The Medicare reimbursement exists. The ADA guidelines endorse the technology. McKesson is building the pharmacy pilot infrastructure. The patients who need the screen are filling their diabetes medications at your counter every week.
The only thing missing is the pharmacist who decides to close the gap.
Sources: Pharmacy Times (McKesson ideaShare 2026: Project Oasis Expansion and New Diabetic Retinopathy Screening Program Explained, June 2026), Pharmacy Times (McKesson ideaShare 2026: Recapping Key Insights from Denver, June 2026), McKesson Corporation (McKesson ideaShare 2026: AI, Advocacy and Community Care Center Stage, June 2026), PMC / American Academy of Ophthalmology (Autonomous Artificial Intelligence in Diabetic Retinopathy Testing: Lessons Learned on Successful Health System Adoption, 2026), American Diabetes Association / Diabetes Care (Artificial Intelligence and Diabetic Retinopathy: AI Framework, Prospective Studies, Head-to-Head Validation, and Cost-Effectiveness), AMA CPT Editorial Panel (Code 92229 Creation and History), CMS Medicare Physician Fee Schedule (CPT 92229 Reimbursement Rate, 2023 and 2024 Updates)