< Billing codes

Billing code

U025A — Dermatology initial e-assessment

First dermatology e-consult

Bill U025 for a dermatologist's first written e-assessment opinion on a patient and diagnosis, requested electronically by a primary care physician or nurse practitioner.

Watch for: Include the requesting physician's or nurse practitioner's provider number on the claim, or it isn't payable.

Code

U025A

Description

Dermatology initial e-assessment

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 dermatologist's first written e-assessment opinion for a patient and diagnosis, at a primary care physician's or NP's secure electronic request.

What it covers

An e-assessment is a specialist's opinion or management advice given after a primary care physician or nurse practitioner sends patient information electronically through a secure server (e.g. secure messaging or EMR); the specialist must review all relevant data sent, including later additions (GP35).

The initial e-assessment is the first one by that specialist for the patient and diagnosis: review all relevant data and give a written opinion with a diagnosis and/or management advice. Its time and intensity equal a regular consultation; a phone reply is allowed but a written opinion is required (GP37).

Billing rules

• Limit: one per patient per specialist per 12 months; two if a second request concerns a clearly different, unrelated diagnosis (GP37).
• A later e-assessment related to the same diagnosis is a repeat, follow-up or minor e-assessment instead (GP37).
• Pay only if you give your opinion or recommendations to the primary care physician or NP within 30 days of the request (GP35).
• Not payable when the purpose is to arrange transfer of care, or a consultation, visit, K-prefix time-based service, procedure or test; or if you give a K-prefix time-based service to the patient within 30 days after the request; or if either physician is paid other than fee-for-service for it (GP35).
• Your chart must hold the patient's name and health number, the requester's name, the date and reason for the request, and your opinion or advice (GP36).
• Include the primary care physician's or NP's provider number on the claim, or it is not payable (GP36).
• A consultation or visit you give within 60 days after the request, same diagnosis, pays only as a specific or partial assessment (GP35).
• Not payable to a supervising physician when a medical trainee provides it (GP81).

Common rejections

• ARF: Missing referring provider number: an e-assessment is only payable with the primary care physician's or nurse practitioner's provider number on the claim (GP36).

Related codes: U023, U026, U021, A025, K738

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Dermatology (02), page A91; rules GP35–GP37.

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