What is OHIP billing code A021?

A021 is "Advanced Dermatology Consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A021 pay?

The current OHIP fee for A021 is $164.90, effective 2025-06-01, per the Ontario Schedule of Benefits.

How do I bill A021 to OHIP?

A021 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A021 claims against the Schedule of Benefits rules before submission.

What codes are related to A021?

Codes related to A021 in the Schedule of Benefits include A020, A025, A027, A020, A021A, A023, A024, A025.

All codes

A021

A021 – Advanced Dermatology Consultation

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
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(this code)
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

A consultation for the investigation, diagnosis, and management of complex diseases of the integumentary system where the complexity of the condition requires the medical expertise of a specialist in Dermatology (02).

Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon

Requires a written request from a referring physician, nurse practitioner, or dental surgeon (for hospital-based dental procedures).

Requires a written report (including findings, opinions, and recommendations) to the referring provider.

A copy of the written request for the consultation, signed by the referring physician, nurse practitioner or dental surgeon must be kept in the consulting physician’s medical record, except in the case of a consultation which occurs in a hospital, long-term care institution or multi-specialty clinic where common medical records are maintained. In such cases, the written request may be contained on the common medical record.

The request identifies the consultant by name and/or the specialty being consulted, the referring physician, nurse practitioner or dental surgeon by name and billing number, and identifies the patient by name and health number.

The written request sets out the information relevant to the referral and specifies the service(s) required.

Where the referral is made by a nurse practitioner, the consultant shall provide the report to the nurse practitioner and the patient’s primary care provider, if applicable.

Usage limits

Limited to one service per patient per physician per two consecutive 12-month periods for the same diagnosis (standard consultation limit). A second consultation for an unrelated diagnosis is permitted once every 12 months.

A020Complex dermatology assessment A025Dermatology Consultation (Standard)A027Consultation in association with special visit (Hospital/LTC)A020 A021A A023 A024 A025 A026 A027 U021 U023 U025 U026

A021 is distinct from A020 (Complex Dermatology Assessment). A021 is for the initial investigation/diagnosis (Consultation), while A020 is for ongoing management (Assessment).

The 30-minute time requirement for psoriasis/dermatitis is specific to the consultation (A021); the assessment (A020) only requires 15 minutes.

Non-patient-facing time (charting, reviewing imaging) is excluded from the time calculation.

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