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Billing code

A680A — Initial Assessment - Substance Abuse

Substance use initial assessment

Bill A680 for an initial substance abuse assessment of at least 50 minutes by the physician who will treat the patient.

Watch for: Chart start and stop times and a DSM diagnosis for each problem substance, or it pays as a lesser assessment.

Code

A680A

Description

Initial Assessment - Substance Abuse

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

Initial substance abuse assessment of at least 50 minutes by the physician who will treat the patient. Usually once per patient per physician or group.

What it covers

A680 is an assessment related to substance abuse in which the physician spends at least 50 minutes in direct contact with the patient, with or without relatives or a representative, excluding time on other separately payable services. It is only payable to the physician who intends to go on to treat the patient's substance abuse (A62).

Required elements include a complete history of illicit drug use, abuse and dependence with a DSM diagnosis for each problematic drug, a complete addiction medicine history, past medical, family and psychosocial history, review of systems, a focused exam when indicated, review of treatment options, a treatment plan, and communication with the patient, family and previous care providers as needed (A62).

Billing rules

• One per patient per physician or practice group, unless 12 months have passed since the same physician's most recent insured service to the patient. Practice group = the same billing group, or co-located with shared access to the chart (A62).
• Not payable for assessing substance abuse related to smoking cessation; see A957, K039 and E079 for that (A62).
• Start and stop times, a DSM diagnosis for each problematic substance, and the information from all elements must be in the chart, or it is paid as a lesser assessment (A63).
• Detention (K001) can only start after 90 minutes (GP30).
• Video only, not telephone, as comprehensive virtual care (AJ2). An A680 by video counts as an existing patient-physician relationship for follow-up virtual care in the next 24 months (A66, A67).
• In hospital the code is C680, subject to the same conditions (A63).

Often billed with

• K300A modality indicator when the assessment is done by video (A70).

Related codes: C680, K680, A957, K682, K683, K039

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Family Practice & Practice in General (00), Addiction medicine, pages A62 to A63

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