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Billing code

A252A — Initial vision rehabilitation assessment

First low vision rehabilitation

An ophthalmologist bills A252 for the first vision rehabilitation assessment of low acuity, a field defect or oculomotor dysfunction, doing 4 of 8 components.

Watch for: Maximum 2 per patient per physician per 5 years; fewer than 4 components pays a lesser fee.

Code

A252A

Description

Initial vision rehabilitation assessment

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

Ophthalmologist's first vision rehabilitation assessment for low visual acuity, a visual field defect or significant oculomotor dysfunction.

What it covers

A252 is an initial vision rehabilitation assessment by an ophthalmologist of a patient with low visual acuity (best corrected 20/50 or worse in the better eye), a visual field defect, or significant oculomotor dysfunction, not amenable to further medical or surgical treatment (A157).

At least 4 of 8 components must be done at the visit: cognitive assessment; residual visual function testing (at least two listed tests); eccentric preferred retinal loci; near functional acuity with ETDRS charts; reading skills; prescribing low vision devices; a vision rehabilitation plan and/or discussion; supervised training (A157).

Billing rules

• If fewer than 4 components are done, it pays as a lesser fee (A158, rule 5).
• No other assessment or consultation by the same physician for the same patient the same day is payable (A157, rule 1).
• Maximum 2 per patient per physician per 5 years (A157, rule 2).
• Follow-ups are A254 (at least 3 components), payable only after an A252, up to 10 per patient per 5 years from the most recent A252 (A157–A158).
• Diagnostic services such as visual field testing are payable in addition when done (A158 commentary).
• Not on the Appendix J virtual care lists, so not payable as virtual care (AJ1–AJ2).

Often billed with

• Diagnostic tests such as visual field testing (A158 commentary).

Common rejections

• A4D: 'Invalid specialty for this service code': ophthalmology codes are for specialty 23. Specialists must bill from their own specialty's listings (GP9).
• AM1: 'Service limit exceeded': more than 2 A252 for this patient by you in 5 years (A157).

Related codes: A254, A233, A235, A251, A230

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Ophthalmology (23), page A157.

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