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Billing code

A935A — Special Surgical Consultation (see General Preamble Gp19)

Special surgical consultation

Bill A935 for a surgical consultation with all consultation elements plus at least 50 minutes of direct patient contact.

Watch for: Record start and stop times in the chart, or it isn't payable; the written referral with billing number is required.

Code

A935A

Description

Special Surgical Consultation (see General Preamble Gp19)

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

Special surgical consultation: every element of a consultation plus at least 50 minutes of direct contact with the patient. Start and stop times required.

What it covers

A935 is the special surgical consultation, listed under 11 surgical specialties: cardiac, general, general thoracic, neurosurgery, obstetrics and gynaecology, ophthalmology, orthopaedic, otolaryngology, plastic, urology and vascular surgery (A81 and each surgical specialty listing).

The surgeon provides all the elements of a regular consultation and spends at least 50 minutes in direct contact with the patient. The time excludes any other separately billable service and non-patient-facing time such as reviewing charts, imaging or documentation (GP19-GP20).

Billing rules

• Bill A935 or C935 as applicable; C935 is the hospital in-patient listing (GP20, A81).
• Record start and stop times in the chart; a service with a minimum time is not eligible for payment without them (GP7).
• All consultation requirements apply: a signed written request from a physician, nurse practitioner or dental surgeon kept on file, and a written report back to the referrer (GP16).
• Time-based consultations such as A935 count toward the consultation limits: one per patient per two consecutive 12-month periods for the same diagnosis, one per 12 months for an unrelated diagnosis (GP17-GP18).
• The surgical fee doesn't include the major pre-operative visit, so A935 is payable when it is the visit where the decision to operate is made (GP4, SP2).
• Detention (K001) can only start after 90 minutes (GP30).
• Specialist consultations for children pay an age premium: 30% under 30 days, 25% to age 1, 20% to age 2, 15% to age 5 and 10% from 5 to 15 years (GP64).
• Payable by video only, never telephone, as comprehensive virtual care with K300A (AJ2, A70).

Often billed with

• U990 first person and U991 additional person seen premiums for a non-elective special visit to a hospital out-patient department on a weekday between 07:00 and 17:00; in daytime the first person premium is payable only when a travel premium is (U992/U993 apply with sacrifice of office hours). Maximum 10 patients, first and additional combined, per time period, and the time of the visit must be charted (GP65-GP66, GP69, GP71).
• K300A when the consultation is done by video (A70, AJ2).
• A Z-prefix procedure the same day, such as Z106 or Z543: when the decision to operate is made at this consultation, no other assessment before the procedure is payable that day (SP4).

Common rejections

• AC4: The referring provider number was missing, mistyped, your own number, or from a provider type that can't refer for this code. Enter the referrer's six-digit number from the written request (GP16).

Related codes: C935, A095, A096, A093, U990, U991

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Cardiac Surgery (09) and the other surgical specialty listings, page A81; General Preamble GP16-GP20 (consultation, special surgical consultation), GP7, GP30 and GP64

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