RT Book, Section
A1 Buffington, Daniel E.
A2 Angaran, David M.
A2 Whalen, Karen
SR Print(0)
ID 1102488295
T1 Reimbursement for Pharmacist Services
T2 Medication Therapy Management: A Comprehensive Approach
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 9780071848695
LK accesspharmacy.mhmedical.com/content.aspx?aid=1102488295
RD 2024/04/19
AB Medical  service  billing  is  an  essential  process  between  a  healthcare  provider  and  a  payer.In  the  United  States,  the  medical  service  billing  system  is  based  on  the  American  Medical  Association's  (AMA)  Current  Procedural  Terminology  (CPT)  coding  system.Pharmacist  providers  billing  for  patient  care  services  must  obtain  and  use  a  National  Provider  Identifier  (NPI)  number  for  both  service  documentation  and  claim  forms.Medication  therapy  management  services  (MTMS)  codes  (99605,  99606,  and  99607)  were  devel-oped  specifically  to  describe  pharmacists'  patient  care  services."Incident  to"  billing  is  when  a  physician  serves  as  the  primary  billing  party  to  facilitate  payment  for  patient  care  services  provided  by  other  healthcare  professionals  or  staff  members.The  Transitional  Care  Management  Services  (TCMS)  codes  were  added  to  the  AMA  CPT  code-book  in  2013  and  reflect  the  importance  of  reducing  hospital  readmissions.The  Complex  Chronic  Care  Coordination  (CCCC)  codes  describe  patient-centered  management  and  clinical  support  services  provided  by  a  physician  or  other  qualified  healthcare  provider  and  their  staff  on  an  outpatient  basis  on  a  per  month  basis.It  is  imperative  to  identify  and  confirm  whether  the  payer  will  pay  for  the  services  before  the  services  or  procedures  are  provided.