A253

PDF page 195 / A67

CONSULTATIONS AND VISITS
 VIRTUAL CARE SERVICES
                    • A801 – Comprehensive midwife or Aboriginal Midwife-requested genetic
                      assessment by Video,
                 • A800 – Midwife or Aboriginal Midwife-requested genetic assessment by Video,
                 • A253 – Optometrist-Requested Assessment (ORA) by Video,
                 • A256 – Special optometrist-requested assessment by Video,
                 • A957 – Addiction medicine FPA by Video,
                 • K680 – Substance abuse – extended assessment by Video.
          [Commentary:
          1.Follow-up Virtual Care Services provided in the 24-months subsequent to the services listed
            in 3 or 4 may be claimed as Comprehensive Virtual Care Services.]
          GP Focused Practice Physician means, for the purpose of eligibility to provide a focused
          practice consultation by Video (A010, A011, A906, A913, A914), a physician who has been
          designated by the bi-lateral MOH-OMA GP Focused Practice Review Committee or a physician
          who is eligible for the focused practice psychotherapy premium.
          Limited Virtual Care Service means a Virtual Care Service rendered where an Existing/
          Ongoing Patient-Physician Relationship does not exist, and in the physicians’ professional
          opinion in accordance with accepted professional standards and practice, the person's care
          and support requirements can be effectively and appropriately delivered by Video or
          Telephone.
          Verified-Virtual Visit Solution means virtual service delivery platforms listed on Ontario
          Health’s public list of verified solutions.
          Virtual Care Service means a service provided using information technologies to render
          eligible services to patients remotely.

PDF page 287 / A159

CONSULTATIONS AND VISITS
 OPHTHALMOLOGY (23)
        Optometrist-requested assessment (ORA)
         Optometrist-requested assessment (ORA) is an assessment of a patient provided by an
         ophthalmologist upon the written request of an optometrist because of the complex, obscure or
         serious nature of the patient’s problem. Urgent or emergency requests may be initiated verbally
         but must also be documented in writing. The ORA includes the common and specific elements
         of a specific assessment.
   A253 Optometrist-Requested Assessment (ORA) ...........................              86.25
       Payment rules:
       1.This service is limited to one per patient, per physician, per 24 month period.
          2.The ophthalmologist must submit his/her findings, opinions and recommendations in writing
            to both the optometrist and the patient’s primary care physician or nurse practitioner, if
            applicable, or the amount payable for the service will be reduced to a lesser fee.
          Medical record requirements:
          The written request from the optometrist must be retained on the patient’s permanent medical
          record, or the amount payable for the service will be reduced to a lesser fee.

PDF page 287 / A159

Special optometrist-requested assessment
         A Special Optometrist-Requested Assessment is an assessment in which the ophthalmologist
         provides all the elements of an Optometrist-Requested Assessment (A253) and spends a
         minimum of 50 minutes in direct contact with the patient, exclusive of time spent rendering any
         other separately billable intervention to the patient.
   A256 Special optometrist-requested assessment............................           194.65
       Payment rules:
       This service is limited to one per patient, per physician, per 24 month period.
          Medical record requirements:
          The service is eligible for payment only if start and stop times of the service are recorded in the
          patient's permanent medical record.

PDF page 287 / A159

Optometrist-requested assessment for Uveitis and Ocular Inflammatory Diseases
       Optometrist-requested assessment for uveitis and ocular inflammatory diseases is an
       assessment in which the ophthalmologist provides all the elements of an Optometrist-
       Requested Assessment (A253) for a patient with a uveitis, ocular inflammatory or orbital
       inflammatory disorder.
   A931 Optometrist-requested assessment for uveitis and ocular
            inflammatory diseases........................................................ 157.00
          Payment rules:
          1.A931 is only eligible for payment to an ophthalmologist with fellowship training in uveitis and
            ocular inflammatory diseases
          2.A931 is only eligible for payment for the assessment of a patient with a uveitis, ocular
            inflammatory or orbital inflammatory disorder
          3.A931 is only eligible for payment when the following are documented as part of the
            examination:
              a.Dilated examination of the fundus; and

PDF page 288 / A160

Optometrist-requested assessment for Neuro-ophthalmic Disorders
     Optometrist-requested assessment for neuro-ophthalmic disorders is an assessment in which
     the ophthalmologist provides all the elements of an Optometrist-Requested Assessment
     (A253) for a patient with a neuro-ophthalmic disorder.
 A241 Optometrist-requested assessment for neuro-ophthalmic
          disorders............................................................................. 155.45
      Payment rules:
      1.A241 is only eligible for payment when at least four of the following are documented as a part
        of the examination:
          a.Detailed pupillary examination (includes pharmacological testing as applicable)
          b.Detailed extraocular motility examination
          c.Ocular alignment testing
          d.Partial or complete neurological examination
          e.Detailed examination of the fundus
          f. Analysis of formal visual field test(s)
          g.Analysis of pertinent diagnostic imaging studies
      2.A241 is only eligible for payment to an ophthalmologist with fellowship training in Neuro-
        ophthalmology.
      3.A241 is only eligible for payment for the assessment of a patient with a neuro-
        ophthalmological disorder.
      4.This service is limited to one per patient, per physician, per 24 month period.
      [Commentary:
      In circumstances where a neuro-ophthalmologist renders an assessment service to a patient
      who is not referred for a neuro-ophthalmology assessment or, where the patient does not have
      a neuro-ophthalmological disorder, see general listings.]

PDF page 826 / AJ2

APPENDIX J
VIDEO ONLY
     A010A, A011A, A015A, A016A, A021A, A025A, A026A, A035A, A036A,
     A045A, A046A, A050A, A055A, A056A, A065A, A066A, A075A, A076A,
     A085A, A086A, A095A, A096A, A116A, A130A, A135A, A136A, A150A,
     A155A, A156A, A160A, A165A, A166A, A175A, A176A, A180A, A185A,
     A186A, A190A, A191A, A192A, A195A, A196A, A197A, A198A, A205A,
     A206A, A210A, A220A, A223A, A225A, A226A, A235A, A236A, A245A,
     A246A, A253A, A255A, A256A, A260A, A265A, A266A, A275A, A285A,
     A286A, A315A, A316A, A320A, A325A, A335A, A345A, A346A, A355A,
     A356A, A365A, A375A, A385A, A395A, A400A, A405A, A415A, A416A,
     A425A, A435A, A445A, A446A, A460A, A465A, A466A, A470A, A475A,
     A476A, A485A, A486A, A515A, A525A, A545A, A565A, A575A, A580A,
     A586A, A590A, A595A, A600A, A605A, A606A, A615A, A616A, A625A,
     A626A, A635A, A636A, A645A, A646A, A655A, A662A, A665A, A667A,
     A675A, A680A, A682A, A695A, A710A, A715A, A720A, A725A, A726A,
     A735A, A745A, A770A, A775A, A795A, A800A, A801A, A802A, A814A,
     A817A, A818A, A835A, A845A, A865A, A906A, A913A, A914A, A915A,
     A925A, A935A, A945A, C010A, C013A, C014A, C015A, C016A,
     C020A, C023A, C024A, C025A, C026A, C033A, C034A, C035A, C036A,
     C043A, C044A, C045A, C046A, C051A, C053A, C054A, C055A, C063A,
     C064A, C065A, C066A, C071A, C073A, C074A, C075A, C076A, C083A,
     C084A, C085A, C086A, C093A, C094A, C095A, C096A, C111A, C113A,
     C114A, C116A, C130A, C131A, C133A, C134A, C135A, C136A, C150A,
     C151A, C153A, C154A, C155A, C156A, C160A, C161A, C163A, C164A,
     C165A, C166A, C173A, C174A, C175A, C176A, C180A, C181A, C183A,
     C184A, C185A, C186A, C190A, C193A, C194A, C196A, C203A, C204A,
     C205A, C206A, C210A, C220A, C223A, C225A, C226A, C233A, C234A,
     C235A, C236A, C243A, C244A, C245A, C246A, C255A, C260A, C263A,
     C264A, C265A, C266A, C270A, C275A, C283A, C285A, C286A, C311A,
     C313A, C314A, C315A, C316A, C320A, C325A, C335A, C341A, C343A,
     C344A, C345A, C346A, C353A, C354A, C355A, C356A, C365A, C375A,
     C385A, C395A, C411A, C413A, C414A, C415A, C416A, C425A, C435A,
     C441A, C443A, C444A, C445A, C446A, C460A, C461A, C463A, C464A,
     C465A, C466A, C470A, C471A, C473A, C474A, C475A, C476A, C480A,
     C481A, C483A, C484A, C485A, C486A, C510A, C511A, C515A, C545A,
     C565A, C570A, C575A, C580A, C585A, C586A, C590A, C595A, C600A,
     C601A, C603A, C604A, C605A, C606A, C611A, C613A, C614A, C615A,
     C616A, C623A, C624A, C625A, C626A, C635A, C643A, C644A, C645A,
     C646A, C655A, C661A, C662A, C665A, C667A, C675A, C680A, C682A,
     C695A, C720A, C721A, C723A, C724A, C725A, C726A, C710A, C713A,
     C715A, C735A, C745A, C760A, C770A, C775A, C795A, C845A, C865A,
     C895A, C915A, C925A, C935A, C945A, K630A, W025A, W026A,
     W075A, W076A, W130A, W150A, W155A, W156A, W165A, W185A,
     W190A, W196A, W235A, W236A, W275A, W310A, W355A, W356A,
     W375A, W395A, W425A, W435A, W465A, W466A, W510A, W511A,
     W515A, W516A, W535A, W720A, W725A, W726A, W770A, W775A,
     W795A, W895A, W925A

Master, record 141. Record Layout PDF, page 1.

A25320260401999999990000000000000000000000000008625000000000000000000000000

Auxiliary master fields are preserved as raw scaled values. The linked layout calls them zero-filled, but this edition contains non-zero values. They are not presented as final dollar fees or PDF units.