|Direct inquiries to
Ministry of Health
||CHANGES TO MINISTRY OF
HEALTH SCHEDULE OF BENEFITS FOR OPTOMETRISTS’ SERVICES, EFFECTIVE APRIL 1, 1998
|The Schedule of Benefits for optometrists’ services
will be amended effective April 1, 1998, as follows:
New service definition for Periodic
Oculo-Visual Assessment for the purpose of providing refractive prescriptions for simple
Age specific maximums as follows: under 20
years of age and over 65, one Periodic Oculo-Visual Assessment per person per year;
between 20 and 64 years of age, one Periodic Oculo-Visual Assessment per person per
24-month period (regardless of who provides the service, optometrists or physicians).
One additional Periodic Oculo-Visual
Assessment allowed in the second year for individuals between 20 and 64 years of age only
for significant change in refractive error (defined as 0.5 diopters spherical equivalent)
and due to disease or trauma and not progression of simple refractive error.
The previous one to two years of claim
history will be used to determine if a claim is payable after April 1, 1998. For example,
a 30 year-old patient with a previous eye exam (V401) on June 18, 1997, will be eligible
for a Periodic Oculo-Visual Assessment (V405) after June 19, 1999.
Periodic Oculo-Visual Assessments in excess
of the above are uninsured and may be billed to the patient. Optometrically necessary
assessment for eye disorders other than above will continue to be claimed using V402,
without the above limitations.
V401 is replaced by new age-specific fee
codes (V404, V405, V406 and V407).
Service definition for Oculo-Visual Minor
Assessment. Fee code remains as V402.
Claims for services performed up to and including March 31,
1998, may be submitted after April 1, 1998, and will be processed in the usual manner.
30 Poyntz St.
119 King St. W
P.O. Box 2280, Stn. A
220-808 Robertson St.
1055 Princess St.
P.O. Box 9000
Canada Life Square
235 King St. E.,
217 York St., 5th FloorP.O. Box 5700
201 City Centre Dr.
P.O. Box 7020, Stn. A
101-447 McKeown St.
419 King St. W.
P.O. Box 635 L1H 8L4
75 Albert Street
981 2nd Avenue E.
550 Lansdowne St. W.
59 Church St
452 Christina St. N.
Roberta Bondar Place
70 Foster Dr., Ste. 100
199 Larch St.,
435 James St. S. ,
38 Pine St. N., Ste. 110
2195 Yonge St.
P.O Box 1700 Stn. A
1427 Ouellette Ave.
P.O. Box 38