Reflectance confocal microscopy (RCM) has recently received Category I Current Procedural Terminology (CPT) codes by the Centers for Medicare & Medicaid Services for reimbursement comparable to a skin biopsy. In this article, we present a review of RCM imaging and its benefits and limitations in diagnosis and treatment planning. We also comment on guidelines for receiving reimbursement for acquiring, reading, and interpreting RCM images.