Billing code
C026A — Dermatology in-patient repeat consultation
Dermatology in-patient repeat consultation
Bill C026 when the same dermatologist consults again on an in-patient's same problem after another physician's care in between.
Watch for: Needs a new written request; if repeat requirements aren't met, OHIP pays an assessment instead.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $0.00 | $47.75 | $0.00 | $0.00 | $0.00 |
- Code
- C026A
- Description
- Dermatology in-patient 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 in-patient consultation by the same dermatologist for the same problem, after another physician's care in between.
What it covers
A repeat consultation is another consultation by the same consultant for the same presenting problem after another physician has cared for the patient in the interval (GP19). C026 is the non-emergency in-patient version (A95).
Billing rules
- Needs a new written request from the referrer (GP19).
- Repeat consultations do not count toward the consultation limits; if the repeat requirements are not met, an assessment is paid instead (GP18).
- For emergency calls and other special visits to in-patients, use the General Listings (A prefix) with premiums instead (A95).
- 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). Virtual in-patient services need all of: you are not the MRP, no physician on staff with the expertise (documented by the referrer), and an in-person assessment by the referrer within 30 days (A69).
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: C025, C023, C024, A026, C028
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Dermatology (02), page A95; rules GP19.
APEX checks every paid claim against the Schedule of Benefits and flags codes billed below what the visit qualified for. See how APEX works · Pricing