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Billing code

A020A — Complex Dermatology Assessment

Complex dermatology follow-up

A dermatologist bills A020 for ongoing management of listed complex conditions, such as complex psoriasis, systemic drug reactions or high skin cancer risk.

Watch for: Must include every element of a specific assessment, and is limited to 6 per patient per physician per 12 months.

Code

A020A

Description

Complex Dermatology Assessment

FHO+ basket

Not in the FHO+ base rate basket (Schedule 2 or 2B).

Effective date

Jun 1, 2025

Termination date

No end date

Explanation

Updated October 26, 2026

Dermatologist's ongoing assessment for listed complex conditions: systemic disease, drug reactions, complex psoriasis/dermatitis, or high skin cancer risk.

What it covers

An assessment for ongoing management of listed conditions that need continuing dermatology care: complex systemic disease with skin signs, prurigo nodularis, complex systemic drug reactions, or complex psoriasis or dermatitis (over 30% body surface area, systemic therapy, or at least 15 minutes of direct contact) (A93).

Also complex skin cancer or high skin cancer risk: melanoma T1b or higher, morpheic basal cell carcinoma, squamous cell carcinoma stage 2 or above, field cancerization (at least 10 actinic keratoses), multiple dysplastic nevi as defined, or other skin neoplasms of uncertain behaviour needing a documented pathology diagnosis (A93, A94).

Billing rules

• Must include all elements of a specific assessment, or OHIP pays a lesser assessment (A94).
• Limit: 6 per patient per physician per 12 months; extra ones pay as a lesser assessment (A94).
• The 15-minute criterion excludes time on other separately payable services and non-patient-facing time (A93, A94). Record start and stop times when you rely on it (GP7).
• Detention (K001) starts only after 60 minutes (GP30).
• For hospital in-patients use C020, which has the same conditions (A95).
• Virtual care by video or phone with an existing patient relationship; add K300A (video) or K301A (phone). Phone pays 85% of the in-person fee (Appendix J AJ1, A66, A70).

Often billed with

• Diagnostic and therapeutic procedures, such as G375/G377 intralesional infiltration, are payable in addition to a consultation or assessment (J3).

Common rejections

• A4D: Invalid specialty for the code; complex dermatology assessments are for continuing management by a dermatology specialist (A93, GP9).
• AT3: Billed as virtual care, but OHIP found no existing patient–physician relationship, such as an in-person service by you in the past 24 months (A66).

Related codes: A023, A024, A021, C020, A025, K001

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Dermatology (02), page A93–A94.

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