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Chapter 10. Reimbursement for Pharmacist Services

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

a. private payment (patient, family, caregivers)

b. health insurance

c. medicare

d. MA-PDs

e. PDPs

The CPT payment code for MTM-only services is:

a. 99605

b. 99495

c. 99487

d. 99211

e. 99215

A superbill is:

a. the same as 99606

b. required by CMS for MTM billing

c. required by PDPs for MTM payment

d. useful for services beyond MTM

e. required in transition care management

A requirement for CPT 99605 is:

a. face-to-face interaction with the patient

b. the patient's goals for therapy

c. a completed care plan

d. a reduction in polypharmacy

e. improvement in patient outcomes

A requirement of incident to billing is:

a. creation of the first care plan

b. an extra payment for the primary provider

c. done in the area where the care was delivered

d. the physician must be physically present

e. adverse drug events must be reduced

Transitional care management services that may be delegated include:

a. collection and review of discharge information

b. determination of need for follow-up activities

c. interaction with other healthcare providers

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

e. All of the above

Care coordination services may include all of the following EXCEPT:

a. communications with the patient ...

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