What is OHIP billing code A020?

A020 is "Complex dermatology assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A020 pay?

The current OHIP fee for A020 is $60.00, effective 2025-06-01, per the Ontario Schedule of Benefits.

How do I bill A020 to OHIP?

A020 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A020 claims against the Schedule of Benefits rules before submission.

What codes are related to A020?

Codes related to A020 in the Schedule of Benefits include C020, A021, A023, A024.

All codes

A020

A020 – Complex dermatology assessment

OHIP Consultations and Visits Code — CONSULTATIONS AND VISITS · Schedule of Benefits

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Levels of this visit

The A02x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A024 Partial assessment
A limited service constituting a history of the presenting complaint, the necessary physical examination, advice to the patient, and an appropriate record.
$23.50
A023 Specific assessment
A specific assessment is a service rendered by a specialist in Dermatology (02) in a place other than the patient's home.
$46.15
A020 Complex dermatology assessment(this code)
An assessment for the ongoing management of complex dermatological conditions where the complexity of the condition requires continuing management by a dermatology specialist.
$60.00

Consultations

A026 Repeat consultation
An additional consultation rendered by the same consultant, in respect of the same presenting problem, following care rendered to the patient by another physician in the interval…
$47.75
A025 Consultation
An assessment rendered following a written request from a referring physician, nurse practitioner or dental surgeon, including a general, specific or medical specific assessment…
$77.50
A027 Consultation in association with special visit
Consultation in association with special visit to a hospital in-patient, long-term care in-patient or emergency department patient.
$158.15
A021 Advanced Dermatology Consultation
A consultation for the investigation, diagnosis, and management of complex diseases of the integumentary system where the complexity of the condition requires the medical…
$164.90

An assessment for the ongoing management of complex dermatological conditions where the complexity of the condition requires continuing management by a dermatology specialist.

Must include all elements of a 'Specific Assessment': a full history of the presenting complaint and a detailed examination of the affected part(s), region(s), or system(s) needed to make a diagnosis, exclude disease, and/or assess function.

The service must be for the ongoing management of one of the following complex conditions:

1. Complex systemic disease with skin manifestations (e.g., sarcoidosis, SLE, dermatomyositis, scleroderma, relapsing polychondritis, IBD with pyoderma gangrenosum/Sweet's/erythema nodosum, porphyria, autoimmune blistering diseases, paraneoplastic syndromes, vasculitis, cutaneous lymphomas).

2. Prurigo nodularis.

3. Complex systemic drug reactions (e.g., drug hypersensitivity syndrome, erythema multiforme major, toxic epidermal necrolysis).

4. Complex psoriasis or complex dermatitis (defined by BSA > 30%, treatment with systemic therapy like biologics/methotrexate, or a visit requiring at least 15 minutes of direct contact).

5. Complex skin cancer or high risk (e.g., high-risk melanoma T1b+, morpheic BCC, SCC stage 2+, field cancerization with 10+ actinic keratoses, multiple dysplastic nevi meeting specific criteria, or other neoplasms requiring pathology diagnosis).

Usage limits

Limited to 6 per patient, per physician, per 12 month period. Services in excess of this limit will be adjusted to a lesser assessment fee.

C020Complex dermatology assessment (Hospital In-patient)A021Advanced Dermatology Consultation A023Specific assessment A024Specific re-assessment

If the service does not include all elements of a specific assessment, the fee will be adjusted to a lesser assessment fee.

Calculation of time (where applicable for the 15-minute criteria) excludes time devoted to other payable services and non-patient-facing time (e.g., chart review, documentation).

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