Wiki 99211 Anticoagulation clinic/pharmacist/NPP

Lisa Bledsoe

True Blue
Greeley, Colorado
Best answers
New question to the age old 99211 issue:

A clinic employed pharmacist does 36416 and 85610...I know we cannot bill 99211 for the pharmacist to adjust the medication even with proper documentation, since they do not meet the requirements as a Medicare provider. HOWEVER - if a Nurse Practitioner is in the office (no physician) and instructs the medication management AND all appropriate documentation is met plus the NP signature...can a 99211 be billed in addition to 85610 and 36416 under the NPP NPI (not incident to)???

Same scenario, but the provider in the office is a PA rather than NP??

OR, does the simple fact that it is a pharmacist that does most of the work negate the use of 99211 altogether?