Billing code
E424A — Paediatric amblyopia assessment premium
Child amblyopia assessment add-on
Add to A233 or A234 when an ophthalmologist assesses a child aged 10 or under in active amblyopia treatment.
Watch for: Must be billed with A233 or A234 and diagnostic code 368.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $0.00 | $50.00 | $0.00 | $0.00 | $0.00 |
- Code
- E424A
- Description
- Paediatric amblyopia assessment premium
- FHO+ basket
- Not in the FHO+ base rate basket (Schedule 2 or 2B).
- Effective date
- Apr 1, 2025
- Termination date
- No end date
Explanation
Updated October 26, 2026
Add-on to A233 or A234 when an ophthalmologist assesses a child aged 10 or under who is in active amblyopia treatment. Diagnostic code 368.
What it covers
Assessment of a paediatric patient with amblyopia (reduced vision in one eye) is a service rendered personally by an ophthalmologist for patients 10 years old or less (A155).
The child must be undergoing active treatment through occlusion therapy, penalization, dichoptic therapy, refractive therapy or similar, to maximize vision in the amblyopic eye(s) (A155).
Billing rules
- Add-on only: bill with A233 or A234 (A155).
- Patients 10 years old or less in active amblyopia treatment (A155).
- Rendered personally by the ophthalmologist (A155).
- Submit with diagnostic code 368 (A155).
- Listed in Appendix J for video or telephone; add K300A (video) or K301A (phone) when there is an existing patient-physician relationship (AJ1, A66, A70).
Often billed with
- A233 or A234 (A155).
- E423 manual cycloplegic refraction for children 15 and under (A155).
Common rejections
- AD9: Premium not allowed alone: E424 must be billed with A233 or A234 (A155).
- AT3: Billed as virtual care but OHIP found no existing patient-physician relationship, such as an in-person service in the past 24 months (A66).
Related codes: A233, A234, E423, A230, K300, K301
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Ophthalmology (23), page A155.
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