How to Choose a Dermatologist: Medical, Surgical and Cosmetic Care

What dermatologists do

The NUCC Health Care Provider Taxonomy, the code set used in NPI records, describes a dermatologist as trained to diagnose and treat children and adults with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails. NUCC adds that dermatologists have additional training in skin cancers, melanomas, moles and other skin tumors, allergic and other skin disorders, and in recognizing skin signs of diseases elsewhere in the body.

Medical, surgical and cosmetic dermatology

Most dermatologists do some of everything, but practices often lean one way. NUCC lists several subspecialty codes a dermatologist can register.

Medical dermatology

Diagnosis and long-term care of skin conditions such as rashes, acne, eczema, psoriasis and infections, and skin checks for suspicious spots. This is what most people need from a first visit.

Mohs micrographic surgery

NUCC describes Mohs surgeons as specialists in both dermatology and pathology who remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Ask whether a skin cancer you have is one that a Mohs surgeon usually treats. NUCC also lists a procedural dermatology code covering surgical methods such as scalpel, laser and cryosurgery, used for health or cosmetic purposes.

Dermatopathology

A dermatopathologist, per NUCC, diagnoses skin diseases by examining tissue samples under the microscope. You may never meet one, but they often read the biopsy your dermatologist takes.

Pediatric dermatology

NUCC describes pediatric dermatologists as having additional training in skin diseases that mainly affect infants, children and adolescents.

Cosmetic dermatology

Treatments aimed at appearance, such as fillers, laser resurfacing or treatment of wrinkles. There is no separate NUCC code for cosmetic dermatology, so ask the practice what share of its work is medical and what is cosmetic.

Who you may see in a dermatology office

Medicare.gov's page on doctor and other health care provider services lists nurse practitioners and physician assistants among the providers whose services Part B covers, and many dermatology practices include them. They examine patients, take biopsies and manage common conditions within the scope their state allows. If you want to see the dermatologist, or want a physician to review a specific concern, ask when you book. Our credentials guide explains the training behind each title.

Dermatologist or esthetician

The Bureau of Labor Statistics describes skincare specialists, also called estheticians, as providing cleansing and other face and body treatments to enhance appearance, such as facials and hair removal. They complete a state-approved cosmetology or esthetician program and pass a state exam, and the BLS notes that they refer clients to a dermatologist for serious skin problems. Their training is in cosmetic skin care, not in diagnosing or treating skin disease. The CDC's page on skin cancer symptoms advises talking to your doctor if you notice changes in your skin.

Checking license and board certification

License

Each clinician must be licensed in the state where you are treated. Physicians are licensed by the state medical board, which you can find through the FSMB's list of state medical boards. Physician assistants are licensed by a state board, in many states the same medical board. Nurse practitioners are licensed by the state board of nursing, and many nurse licenses can be looked up in Nursys. PA national certification can be checked with the NCCPA. Our license guide covers the details.

Board certification

Board certification is voluntary, is granted by a specialty board, and is separate from the license. It is not in NPI or Medicare records, so neither the NPI Registry nor this site can confirm it. For physicians certified by a board in the American Board of Medical Specialties, check Certification Matters; for osteopathic boards, the American Osteopathic Association points patients to the FSMB's DocInfo.org search. A physician who calls themselves a "cosmetic surgeon" or "skin specialist" may be certified in a different specialty, or not certified, so check the board rather than the title.

Insurance and what cosmetic care costs

Medical care

Medicare.gov's doctor services page says Part B covers medically necessary doctor services, which includes dermatology care to diagnose and treat a skin condition, subject to your deductible and coinsurance. Other plans set their own rules. Under Original Medicare, choosing a dermatologist who accepts assignment keeps your share to the deductible and coinsurance, as Medicare.gov's assignment page explains.

Cosmetic care

Medicare.gov's cosmetic surgery page says Medicare usually does not cover cosmetic surgery unless you need it because of accidental injury or to improve the function of a malformed body part. It also lists some services that Medicare usually requires prior authorization for because they are sometimes, but not always, considered cosmetic, including blepharoplasty, botulinum toxin injections and vein ablation. Cosmetic surgery is on Medicare.gov's list of items and services Original Medicare does not cover.

When a treatment could be cosmetic, ask the office before the procedure: will it be billed to my insurance, and if not, what is the total price in writing, including follow-up visits?

What CMS data on a profile can and cannot tell you

Dermatologist profiles on this site may show whether CMS lists them as accepting Medicare assignment, the service codes they billed to Original Medicare in past years, and, where present, Part D prescribing and industry payments reported to Open Payments. The Part B list can show, for example, whether a dermatologist billed Medicare for skin biopsies or Mohs surgery.

The data have limits that CMS states in its methodology: they cover Original Medicare claims only and leave out services provided to 10 or fewer patients. Cosmetic procedures paid out of pocket are not in Medicare data at all. Counts do not measure skill or results, and the data do not show wait times or whether the practice accepts new patients.

Questions to ask

AHRQ's tips for patients suggest writing your questions down and bringing a list of your medicines. For a dermatology visit:

• Will I see the dermatologist, a physician assistant or a nurse practitioner?
• Can you check all of my skin today, or only the spot I came for?
• If you take a biopsy, who reads it, and how and when will I get the result?
• If I need skin cancer surgery, do you do it here or refer me to a Mohs surgeon?
• Is this treatment medical or cosmetic for billing purposes, and what will I owe?

Bring photos if a spot has changed over time, and a list of the products and medicines you use on your skin.

Find a dermatologist near you

On T-MedInfo you can browse clinicians by state and city from the city listings below and open the dermatology listing for your area, or search by name. On each profile, check the specialty codes, practice address and state board link, and confirm network status with your plan. Our specialist checklist covers the remaining steps.