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Billing code

C234A — Ophthalmology specific re-assessment – hospital in-patient

Ophthalmology in-patient re-assessment

Bill when an ophthalmologist re-assesses a non-emergency hospital in-patient with a full relevant history and exam.

Watch for: Limited to 2 per patient per physician in 12 months, except admission assessments; virtual care must be video, not phone.

Code

C234A

Description

Ophthalmology specific re-assessment – hospital in-patient

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

Specific re-assessment by an ophthalmologist for a non-emergency hospital in-patient: full relevant history and exam.

What it covers

The in-patient specific re-assessment for ophthalmology (A162). A specific re-assessment needs a full, relevant history and physical exam of one or more systems (GP23).

An admission assessment counts as a specific re-assessment when a surgeon who assessed the patient before admission for the same illness admits them for a Z-code (IOP) procedure, or when the same physician admits a patient they assessed for the same illness (GP23).

Billing rules

• Limited to 2 per patient per physician per 12 consecutive months, except for hospital admissions. Extras pay at a lesser fee (GP23).
• In-patient rules apply (GP40–GP48). For emergency calls and other special visits to in-patients, use the general listings (A-prefix) and special visit premiums instead (A162).
• Video only. For an in-patient, virtual care is payable only if you aren't the MRP, no local physician with the expertise is available (documented by the referrer), and the referrer assessed the patient in person within 30 days (AJ2, A69).

Common rejections

• AT2: Must include video modality: C234 is video-only by virtual care (AJ2).

Related codes: C233, A234, C232, C235, C238

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Ophthalmology (23), page A162.

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