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Billing code

A023A — Dermatology specific assessment

Dermatology specific assessment

A dermatologist bills A023 for a full history of the complaint and detailed exam of the affected areas, outside the patient's home.

Watch for: One per patient per physician per 12 months, two only for a clearly unrelated diagnosis; extras pay as a lesser assessment.

Code

A023A

Description

Dermatology specific 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

A dermatologist's specific assessment: full history of the complaint and detailed exam of the affected areas, outside the patient's home.

What it covers

A specific assessment is rendered by a specialist outside the patient's home and needs a full history of the presenting complaint and a detailed exam of the affected parts, regions or systems needed to make a diagnosis, exclude disease or assess function (GP23).

A023 is the dermatology office specific assessment (A91).

Billing rules

• Limit: one per patient per physician per 12 months; two if the patient returns with a clearly different, unrelated diagnosis. Extra ones pay as a lesser assessment (GP23).
• Not for visits in the patient's home (GP23).
• Detention (K001) starts only after 60 minutes (GP30).
• A consultation, other assessment or visit you give within 60 days after an e-assessment request for the same diagnosis pays only as a specific or partial assessment (GP35).
• 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).
• A minor procedure plus assessment of a separate, unrelated significant problem in another body system at the same visit: bill both (SP4 §12).

Common rejections

• 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: A024, A020, A025, A026, C023, U023

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Dermatology (02), page A91; rules GP23.

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