What is OHIP billing code A251?

A251 is "Special ophthalmologic assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A251 pay?

The current OHIP fee for A251 is $125.80, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A251 to OHIP?

A251 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A251 claims against the Schedule of Benefits rules before submission.

What codes are related to A251?

Codes related to A251 in the Schedule of Benefits include A256, A250, A252.

All codes

A251

A251 – Special ophthalmologic assessment

OHIP Consultations and Visits Code — CONSULTATIONS AND VISITS · Schedule of Benefits

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Levels of this visit

The A25x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A250 Retinopathy of prematurity assessment
Retinopathy of Prematurity (ROP) assessment is the service rendered by an ophthalmologist for initial assessment or follow-up assessment(s) of a patient with ROP who is either: 9…
$125.80
A251 Special ophthalmologic assessment(this code)
A complete ophthalmologic assessment, rendered by an ophthalmologist, to a person with a psychological problem, developmental delay, learning disability, or significant physical…
$125.80
A254 Follow-up vision rehabilitation assessment
A follow-up vision rehabilitation assessment by an ophthalmologist of a patient with either low visual acuity, visual field defect, or significant oculomotor dysfunction.
$125.80
A252 Initial vision rehabilitation assessment
Initial vision rehabilitation assessment by an ophthalmologist of a patient with either low visual acuity, visual field defect, or significant oculomotor dysfunction, requiring a…
$251.65

Consultations

A255 Limited consultation
A limited consultation is a consultation which is less demanding and, in terms of time, normally requires substantially less of the physician’s time than the full consultation.
$110.15

A complete ophthalmologic assessment, rendered by an ophthalmologist, to a person with a psychological problem, developmental delay, learning disability, or significant physical disability which so limits the person’s participation in the assessment that the physician is required to spend a minimum of 20 minutes in direct contact with the patient, family, and/or legal representative, exclusive of time spent rendering any other separately billable intervention to the patient.

the development of a continuing comprehensive vision care plan;

provision of appropriate information to the patient’s health care team regarding the patient’s vision to allow them to better prepare both general and academic plans;

reporting the findings, opinions or recommendations in writing to other health care team members regarding this evaluation and future planning.

Usage limits

Maximum of 2 services per patient per physician per 12 month period.

A256Special optometrist-requested assessment A250Retinopathy of prematurity assessment A252Major eye examination

The start/stop time of the service must be documented in the patient’s medical record.

A statement of the medical condition and how it limits the patient’s ability to participate in the assessment must be documented.

A copy of the letter to other health care team members must be maintained in the patient’s medical record.

Failure to meet documentation requirements (start/stop times, medical condition statement, or copy of letter) will result in the fee being reduced to a lesser fee.

Calculation of time excludes time devoted to any other separately billable service or procedure.

Calculation of time excludes non-patient-facing time (e.g., reviewing charts, imaging, or documentation).

Not eligible for virtual care (not listed in Appendix J).

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