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Billing code

A027A — Dermatology consultation with special visit (in-patient, LTC or ED)

Dermatology special visit consultation

A dermatologist bills A027 for a consultation on a special visit to a hospital in-patient, long-term care in-patient or emergency department patient.

Watch for: Never bill it alone: claim it with the matching C, W or K special visit premium, plus the referrer's billing number.

Code

A027A

Description

Dermatology consultation with special visit (in-patient, LTC or ED)

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 dermatology consultation on a special visit to a hospital in-patient, long-term care in-patient or emergency department patient, claimed with a premium.

What it covers

A027 is a dermatology consultation given in association with a special visit to a hospital in-patient, long-term care in-patient or emergency department patient (A91).

A special visit is initiated by the patient, or someone for them, for a non-elective service (GP65). For emergency calls and other special visits to in-patients, dermatologists use the General Listings with premiums (A95).

Billing rules

• Claim A027 with the matching special visit premium: C prefix for a hospital in-patient, W prefix for a long-term care in-patient, or K prefix for an emergency department patient (A91).
• Special visit premiums are not payable for patients seen on rounds, with admission assessments of elective admissions, or with H-prefix ED codes (GP65).
• Keep the referrer's written, signed request in the chart. It must name you or the specialty, the referrer and their billing number, and the patient and health number; otherwise OHIP pays a lesser assessment (GP16).
• Same patient, same diagnosis: one consultation per two consecutive 12-month periods. A second is allowed only for a hospital in-patient or ED patient 12 to 24 months after the first (GP17).
• Age premiums apply to specialist consultations and repeat consultations: +30% under 30 days down to +10% for ages 5 to 15 (GP64).
• Not on the Appendix J virtual care lists, so it is not payable as virtual care (Appendix J AJ1–AJ2).

Often billed with

• Hospital in-patient premiums, e.g. C960–C964 travel and C990–C997 / C986–C987 person seen (GP72).
• Emergency department premiums K960–K964 travel and K990–K999 person seen (not payable to ED physicians) (GP70).
• Long-term care premiums W960–W964 and W990–W999 (GP73).

Common rejections

• AD8: Not allowed alone: A027 is claimed together with the appropriate C, W or K special visit premium (A91).
• 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).

Related codes: A025, C025, W025, C960, C990, K960, K990, W990

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Dermatology (02), page A91; special visits GP65–GP78.

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