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Billing code

U026A — Dermatology follow-up e-assessment

Follow-up dermatology e-consult

Bill U026 for a limited follow-up e-assessment when you have already given the patient an insured service for the same diagnosis.

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

Code

U026A

Description

Dermatology follow-up 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 limited follow-up e-assessment by a dermatologist who has already provided an insured service to the patient for the same diagnosis.

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).

A follow-up e-assessment is a limited e-assessment by the specialist who has already given the patient any insured service for the same diagnosis. Its time and intensity equal a partial assessment; you may reply by phone (GP38).

Billing rules

• Limits: one per patient per day, four per patient per 12 months (same physician), and 1,000 per physician per 12 months (GP38).
• 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).
• 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: U025, U023, U021, A024, K738

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Dermatology (02), page A91; rules GP35–GP38.

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