SOMB 2026 Reference

Alberta SOMB Billing Code Guide

PDF-verified Alberta SOMB 2026 code references for family physicians. Every code on this page is sourced directly from the Alberta Schedule of Medical Benefits — no fabricated modifiers, no invented fees.

03.03AOffice Visits
$40.23

Limited Assessment — In Office

Limited assessment of a patient's condition requiring a history related to the presenting problems, a directed examination, and advice. The default GP office visit code.

4 requirements · 3 audit traps
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03.04AOffice Visits
$110.64

Comprehensive Assessment — In Office

Comprehensive in-office assessment requiring a complete history and a complete physical examination. Use only when documentation actually supports a full workup.

4 requirements · 3 audit traps
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03.07AConsultations
$70.39

Minor Consultation — In Office

Minor in-office consultation performed at the request of another physician. Lower complexity than 03.08A.

3 requirements · 3 audit traps
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03.08AConsultations
$131.40

Comprehensive Consultation — In Office

Comprehensive in-office consultation performed at the request of another physician. Requires a complete history, complete physical examination, and a written consult report.

3 requirements · 3 audit traps
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03.03CVTelehealth
$40.23

Assessment via Telephone or Secure Videoconference

Assessment of a patient's condition conducted via telephone or secure videoconference. Substantive clinical work only — not for admin or results-only calls.

3 requirements · 3 audit traps
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03.05JRTelehealth
$20.00

Physician Telephone Call to Patient — Management or Results

Physician-initiated telephone call directly to a patient to discuss management or diagnostic test results. Subject to SOMB frequency and eligibility rules.

3 requirements · 3 audit traps
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03.01ADTelehealth
$20.00

Telephone Advice to Patient or Agent

Advice provided to a patient or their agent (as defined in the Personal Directives Act) via telephone. Strict SOMB rules apply — read the full text before billing.

3 requirements · 3 audit traps
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03.05JBOffice Visits
$54.97

Scheduled Family Conference — Per 15 Minutes

Formal, scheduled family conference relating to a specific patient, billed per 15 minutes or major portion thereof.

3 requirements · 3 audit traps
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03.03DHospital
$43.50

Hospital Visit

In-hospital attendance on an admitted patient.

2 requirements · 2 audit traps
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03.03NOffice Visits
$90.51

Home Visit — First Patient

First patient seen at a home-visit location.

2 requirements · 2 audit traps
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03.03POffice Visits
$40.23

Home Visit — Second / Subsequent Patients (Same Location)

Second and subsequent patients seen at the same home-visit location.

2 requirements · 2 audit traps
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03.04BObstetrics
$110.62

Initial Prenatal Visit — Complete History & Physical

Initial prenatal visit requiring a complete history and complete physical examination. Prenatal-only — not interchangeable with 03.04A.

3 requirements · 2 audit traps
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03.03BObstetrics
$38.99

Prenatal Visit — In Office

In-office prenatal follow-up visit. Prenatal-specific — does not substitute for a regular 03.03A.

2 requirements · 2 audit traps
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13.59AProcedures
$10.73

Intramuscular or Subcutaneous Injection

Administration of an intramuscular or subcutaneous injection. Commonly under-billed when performed alongside an office visit.

2 requirements · 2 audit traps
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98.03AProcedures
$16.69

Incision and Drainage — Abscess or Hematoma

Incision and drainage of a subcutaneous or submucous abscess or hematoma.

2 requirements · 2 audit traps
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98.12AProcedures
$44.39

Excisional Biopsy — Skin

Excisional biopsy of a non-facial skin lesion.

3 requirements · 2 audit traps
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98.12BProcedures
$56.93

Excisional Biopsy — Skin of Face

Excisional biopsy of a skin lesion on the face.

3 requirements · 1 audit traps
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98.12CProcedures
$38.56

Removal of Sebaceous Cyst

Excision of a sebaceous cyst.

2 requirements · 1 audit traps
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98.12HProcedures
$96.09

Excision of Subcutaneous Soft-Tissue Tumor — Per 30 Min

Excision of a subcutaneous soft-tissue tumor, billed per 30 minutes of operating time or major portion thereof.

2 requirements · 2 audit traps
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98.12JProcedures
$19.23

Removal or Excision — First Lesion

Removal or excision of a first lesion (non-cryotherapy, non-fulguration method).

2 requirements · 2 audit traps
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98.12KProcedures
$24.85

Removal by Fulguration — First Lesion

Fulguration removal of a first lesion.

2 requirements · 1 audit traps
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98.12LProcedures
$13.84

Cryotherapy / Chemotherapy — Warts or Keratoses

Non-surgical treatment (cryotherapy or topical chemotherapy) of warts or keratoses. Commonly under-billed alongside routine visits.

3 requirements · 2 audit traps
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98.12QProcedures
$38.94

Removal of Atypical or Neoplastic Lesion(s) — Any Method

Removal of atypical or neoplastic lesion(s) by any method (excluding cryotherapy for actinic keratosis).

3 requirements · 2 audit traps
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