Wiki Pharmacist billing time-based codes

[ishouldberiding]

Is anyone billing time-based codes for pharmacists medication therapy and management services? We currently use 99605-7. I was told today that there is another FQHC that is billing the time-based E/M codes and getting paid. I'm currently trying to find out where they got their information. I wanted to see if anyone else is billing that way.
Thank you,
Shelley

 

[Cheezum51]

I believe that the E/M codes are for services provided by a physician. To my knowledge, pharmacists are not covered by that definition. Just because someone else is getting paid for filing a certain code, doesn't mean what they're filing is correct.

Tom Cheezum, OD, CPC, COPC

 

[Kristen Bensel]

I work for a Tribal 638 clinic (IHS) and we utilize internal pharmacists for chronic care management services, but these encounters can not be billed higher than a 99211, and have to be done incident to the patients provider. This can be done due to the pharmacist being considered an ancillary staff member of the provider.
I know there is an IHS clinic in Washington that submits claims with higher EM for pharmacist chronic care visits, however, you have to remember different states have different rules for provider types. And sometimes the state may allow pharmacists to provide certain services, but the payer may not consider them a billable provider type.

It is also hard when the pharmacist is imbedded in a physician clinic vs a free standing pharmacy.