Billing code
A237A — Periodic Oculo-visual Assessment - Aged 19 Years And Below
Child routine eye exam
An ophthalmologist bills A237 for a periodic eye and vision exam, mainly for simple refractive error, in a patient aged 19 or younger.
Watch for: Only for ages 19 and under, one per 12 months across all physicians and optometrists; use A239 for patients 65 and over.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $0.00 | $59.35 | $0.00 | $0.00 | $0.00 |
- Code
- A237A
- Description
- Periodic Oculo-visual Assessment - Aged 19 Years And Below
- FHO+ basket
- Not in the FHO+ base rate basket (Schedule 2 or 2B).
- Effective date
- Apr 1, 2026
- Termination date
- No end date
Explanation
Updated October 26, 2026
Periodic eye and vision exam by an ophthalmologist for a patient aged 19 or younger, mainly to check for simple refractive error.
What it covers
A periodic oculo-visual assessment is an exam of the eye and vision system done mainly to find out whether a patient aged 19 or less has a simple refractive error (myopia, hypermetropia, presbyopia, anisometropia or astigmatism) (GP28).
It includes all components needed, ordinarily history, past medical history, visual acuity, ocular mobility, slit lamp exam of the anterior segment, ophthalmoscopy and tonometry, plus advice and a written refractive prescription if required (GP28).
Billing rules
- Patients aged 19 years and below (A156, GP28).
- Limited to 1 per patient per 12 months, whether done by you, another physician, or an optometrist (as a major oculo-visual examination). Extra services are not insured (GP28).
- Patients aged 20 to 64 are not insured for this service (GP28).
- Ophthalmologists are exempt from the rule that blocks other services by the same physician on the same day (GP28).
- Don't substitute another consultation or visit code once the limit is reached (GP28).
- A re-assessment after a periodic oculo-visual assessment is billed with a lesser assessment code and diagnostic code 367 (GP28).
- Not listed in Appendix J, so not payable as a virtual service (AJ1–AJ2).
Common rejections
- A2A: Outside of age limit: A237 is for patients 19 and under; use A239 for patients 65 and over (A156).
Related codes: A239, A110, A112, A115, E423, A233
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Ophthalmology (23), page A156. Rules on GP28.
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