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Chapter 10. Reimbursement for Pharmacist Services

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Payment to the pharmacist for MTM services may come from all of the following EXCEPT:

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a. private payment (patient, family, caregivers)

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b. health insurance

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c. medicare

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d. MA-PDs

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e. PDPs

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The CPT payment code for MTM-only services is:

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a. 99605

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b. 99495

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c. 99487

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d. 99211

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e. 99215

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A superbill is:

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a. the same as 99606

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b. required by CMS for MTM billing

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c. required by PDPs for MTM payment

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d. useful for services beyond MTM

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e. required in transition care management

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A requirement for CPT 99605 is:

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a. face-to-face interaction with the patient

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b. the patient's goals for therapy

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c. a completed care plan

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d. a reduction in polypharmacy

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e. improvement in patient outcomes

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A requirement of incident to billing is:

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a. creation of the first care plan

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b. an extra payment for the primary provider

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c. done in the area where the care was delivered

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d. the physician must be physically present

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e. adverse drug events must be reduced

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Transitional care management services that may be delegated include:

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a. collection and review of discharge information

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b. determination of need for follow-up activities

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c. interaction with other healthcare providers

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d. coordination of follow-up activities with other providers and services

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e. All of the above

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Care coordination services may include all of the following EXCEPT:

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a. communications with the patient ...

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