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Billing code

A253A — Optometrist-requested Assessment (ora)

Optometrist-requested eye assessment

An ophthalmologist bills A253 for an assessment on an optometrist's written request because the problem is complex, obscure or serious.

Watch for: Limited to 1 per patient per physician per 24 months; send written findings to the optometrist and primary care provider.

Code

A253A

Description

Optometrist-requested Assessment (ora)

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

Assessment by an ophthalmologist on the written request of an optometrist for a complex, obscure or serious problem. Once per 24 months.

What it covers

An optometrist-requested assessment (ORA) is an assessment by an ophthalmologist on the written request of an optometrist because of the complex, obscure or serious nature of the patient's problem. Urgent or emergency requests can start verbally but must also be documented in writing (A159).

The ORA includes the common and specific elements of a specific assessment (A159).

Billing rules

• Limited to 1 per patient per physician per 24 months (A159).
• Send your findings, opinions and recommendations in writing to the optometrist and to the patient's primary care physician or nurse practitioner, if any, or it pays at a lesser fee (A159).
• Keep the optometrist's written request in the patient's chart, or it pays at a lesser fee (A159).
• Video only (no telephone) with an existing relationship; add K300A (AJ2, A70). An ORA by video also creates a relationship for later virtual follow-up within 24 months (A67).
• Detention (K001) may start after 60 minutes (GP30).

Often billed with

• A230 orthoptic assessment (A156).
• Ophthalmology diagnostic tests such as OCT or visual fields (J3, J91, J93).

Common rejections

• AM1: Service limit exceeded: A253 is limited to 1 per patient per physician per 24 months (A159).
• AT2: Must include video modality: A253 by virtual care is video-only (AJ2).

Related codes: A256, A931, A241, A235, A233, A234

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Ophthalmology (23), page A159.

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