What are the billing rules for A026A?

Needs a new written, signed request from the referring physician, nurse practitioner or dental surgeon (GP19, GP16). Repeat consultations do not count toward the consultation limits (GP18). If the repeat consultation requirements are not met, OHIP pays an assessment instead (GP18).

What is A026A often billed with?

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

Why is A026A rejected?

ARF: The claim is missing the referring provider's number. A consultation follows a written request that names the referrer and their billing number (GP16). AT2: This code is video only in Appendix J; billing it with the phone indicator K301A is not allowed (AJ2, A70).

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Billing code

A026A — Dermatology repeat consultation

Q: What is OHIP billing code A026A?

A repeat consultation by the same dermatologist for the same problem, after another physician has cared for the patient in between.

Dermatology repeat consultation

A dermatologist bills A026 for another consultation on the same problem after another physician cared for the patient in between.

Watch for: Needs a new written, signed request and the referrer's billing number on the claim; otherwise OHIP pays an assessment instead.

Provider	Specialist	Assistant	Anaesthetist	Non-anaesthetist
$0.00	$47.75	$0.00	$0.00	$0.00

Code: A026A
Description: Dermatology repeat consultation
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 repeat consultation by the same dermatologist for the same problem, after another physician has cared for the patient in between.

What it covers

A repeat consultation is another consultation by the same consultant for the same presenting problem, after care by another physician in the interval since the first consultation (GP19).

It has the same requirements as a consultation, including a new written request from the referrer (GP19). A026 is the dermatology office repeat consultation (A91).

Billing rules

Needs a new written, signed request from the referring physician, nurse practitioner or dental surgeon (GP19, GP16).
Repeat consultations do not count toward the consultation limits (GP18).
If the repeat consultation requirements are not met, OHIP pays an assessment instead (GP18).
Detention (K001) starts only after 60 minutes (GP30).
Age premiums apply to specialist consultations and repeat consultations: +30% under 30 days down to +10% for ages 5 to 15 (GP64).
Virtual care: video only (Appendix J AJ2), with an existing patient relationship and the K300A video indicator; not payable by phone (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

ARF: The claim is missing the referring provider's number. A consultation follows a written request that names the referrer and their billing number (GP16).
AT2: This code is video only in Appendix J; billing it with the phone indicator K301A is not allowed (AJ2, A70).

Related codes: A025, A021, A023, A024, C026, A027

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Dermatology (02), page A91; rules GP19.

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