< Billing codes

Billing code

A239A — Periodic Oculo-visual Assessment - Aged 65 Years And Above

Senior routine eye exam

An ophthalmologist bills A239 for a periodic eye and vision exam, mainly for simple refractive error, in a patient aged 65 or older.

Watch for: Only for ages 65 and over, one per 12 months across all physicians and optometrists; use A237 for patients 19 and under.

ProviderSpecialistAssistantAnaesthetistNon-anaesthetist
$0.00$59.35$0.00$0.00$0.00
Code
A239A
Description
Periodic Oculo-visual Assessment - Aged 65 Years And Above
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 65 or older, 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 65 or more 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 65 years and above (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: A239 is for patients 65 and over; use A237 for patients 19 and under (A156).

Related codes: A237, A112, A110, A115, A233, A234

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Ophthalmology (23), page A156. Rules on GP28.

APEX checks every paid claim against the Schedule of Benefits and flags codes billed below what the visit qualified for. See how APEX works · Pricing