Background: The increasing incidence of basal cell carcinoma demands for an improvement of current health care management to gain more efficacies in the interdisciplinary treatment of facial basal cell carcinoma. We prospectively evaluated the level of agreement between referring dermatologists and plastic surgeons to assess in which cases routine pre-operative consultation of patients with facial basal cell carcinoma was not required for surgical treatment by plastic surgeons. Methods: The outcome of a self-designed standardized referral form was prospectively evaluated in 100 patients with clinically suspected facial basal cell carcinoma that were referred from the dermatology outpatient clinic to the surgical outpatient clinic of Plastic Surgery for tumor removal under local anesthetics between 2009 and 2011. Results: The level of agreement between the dermatologists and plastic surgeons on whether patients could be booked on the surgical outpatient clinic without routine pre-operative consultation was categorized as 'moderate agreement' (Kappa = 0.589). We found that in 12.7 % of the patients with high-risk facial basal cell carcinoma (BCCs), both specialists agreed that pre-operative consultation was not required. In another 12.7 % of the patients, consensus was not achieved. In 74.6 % of the patients, both specialists agreed that pre-operative consultation was recommended. Conclusions: We found that in selected patients with high-risk facial BCCs, both specialists agreed that pre-operative consultation was not required. Once a standardized referral system has been implemented, its use may improve efficacy in the surgical treatment of high-risk facial BCC. Future research should be directed towards clinical controlled trials. Level of Evidence: Level III, risk/prognostic study. [ABSTRACT FROM AUTHOR]