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Billing code

U233A — Ophthalmology repeat e-assessment

Ophthalmology repeat e-assessment

Bill for your first e-assessment after your own initial e-assessment or consultation for the same patient and diagnosis.

Watch for: Put the requesting physician's or nurse practitioner's provider number on the claim; limit is 1 per patient per 12 months.

Code

U233A

Description

Ophthalmology repeat e-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

The first e-assessment after an initial e-assessment or consultation by the same ophthalmologist, for the same diagnosis.

What it covers

An e-assessment is a specialist's opinion and/or recommendations for managing a specific patient, given in response to a primary care physician's or nurse practitioner's request sent through a secure electronic system. The specialist must review all relevant data provided, including information sent later (GP35).

A repeat e-assessment is the first e-assessment by a specialist after their initial e-assessment or consultation, for the same diagnosis. Time and intensity are the same as a specific assessment (GP37).

Billing rules

• Limited to 1 per patient per physician per 12 months, or 2 for a clearly different, unrelated diagnosis (GP37).
• The request must come electronically through a secure system (e.g. secure messaging, EMR) from the patient's primary care physician or nurse practitioner (GP35).
• Send your opinion and/or recommendations within 30 days of the request (GP35).
• Not payable if the purpose is to transfer care or to arrange a consultation, visit, procedure, test or K-prefix time-based service, or if you bill a K-prefix time-based service for the patient within 30 days (GP35).
• A consultation, assessment or visit by you for the same diagnosis within 60 days of the request pays only as a specific or partial assessment (GP35).
• Chart the patient's name and health number, the requester's name, the date and reason for the request, and your opinion (GP36).
• Include the primary care physician's or nurse practitioner's provider number on the claim (GP36).

Often billed with

• K738 to the primary care physician only when new data had to be collected (GP35).

Common rejections

• ARF: Missing referring physician number: an e-assessment claim must include the requesting primary care physician's or NP's provider number (GP36).

Related codes: U235, U236, U231, K738, A233

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Ophthalmology (23), page A155. Rules on GP35–GP37.

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