Family physician's first report after the initial assessment when injuries did not cause missed work/school or significant impairment of daily living.
- Completed by
- Family physician
- Issued by
- ICBC
- Format
- Fillable PDF
- Language
- English
ICBC Scarring Measurement Report: Fee Code A94575
ICBC asks a practitioner to complete this report when it needs measurements of a customer's permanent scarring to assess permanent impairment after a crash. Physicians, chiropractors, kinesiologists, occupational therapists, physiotherapists and registered massage therapists are all eligible to complete it, but ICBC funds the report only after an ICBC Claims Contact requests it.
Who completes it
The practitioner ICBC contacts completes the whole report on the template ICBC supplies with its request. According to ICBC's program guides, the Claims Contact gets in touch when a scarring report is required for benefit administration.
Submitting and payment
- How to submit it
- Physicians send a separate invoice for each report with the claim number, date of accident, payee name and address, patient name and report date. Recovery Network providers bill it in HCPIR or HCPP by selecting Scarring Measurement Report.
- Who pays
- Physicians bill fee code A94575, and other eligible practitioners receive the per-report fee set in ICBC's Fee Schedule for Health Care Providers (CL534).
Good to know
- Chiropractors and kinesiologists measure scarring during a regularly scheduled treatment session, which can be invoiced separately from the report.
- Occupational therapists may invoice up to 15 minutes of assessment time separately for a scarring measurement report.
- ICBC's OT program guide identifies the scarring measurement report as CL736 and bills it apart from miscellaneous form completion.
Get the official form
Download the current version from the source each time; forms change without notice.
Scarring measurement report
Fill it with Vero
If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.
How this list is checked
A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms change without notice, so download the current version from the official page before you fill it in.
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Frequently asked questions
When does ICBC ask for a scarring measurement report?
ICBC's physicians page says the report is completed only upon ICBC's request and applies to permanent scars. The program guides add that the ICBC Claims Contact contacts the practitioner when the report is required for benefit administration, and that ICBC funds it only in that case.
How do physicians bill the ICBC scarring report?
Physicians bill fee code A94575 with a separate invoice for each report. The invoice must include the claim number, date of accident, payee name and address, patient name and report date. The related range of motion loss report uses fee code A94577.