Results 1 to 4 of 4

Billing for a PharmD in physician office

  1. #1
    Sioux Falls South Dakota
    Default Billing for a PharmD in physician office
    Exam Training Packages
    I was asked a question today that has me stumped. Our specialty clinics want to hire a PharmD who would help manage patients with multiple medications. The first clinic would be Medical Oncology, and the second that is thinking about it is Endocrinology. I have heard of a PharmD being part of the team in the inpatient setting, and even part of a case management team. However, they (the clinics) want to be able to bill out E/M for visits with the PharmD. I don't think that is possible; I have searched and don't find that they would qualify for "incident to" - and although they can get NPI numbers, I don't see where Medicare credentials them under Part B to provider Part B services. I would think other insurance companies would be the same. Our credentialing specialist is looking into that part.

    Does anyone have any experience with billing out services for a PharmD? Any help would be appreciated.

    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

  2. #2
    Tucson Cactus Coders
    Just wondering if you have any success in researching the incident to billing for Pharm D. visits?

  3. Default PharmD
    This same thing just happened in our office and I was wondering what the outcome was.

    I do not think that they should be billing incident to either but our physicians say they can.

    Any clarification would be greatly appreciated.

    thank you

  4. #4
    Jonesboro Chapter
    I am not sure if this helps. We are a teaching facility/clinic and we have 2 PharmD's on our staff. They do work with the med rec of the patient medication with the staff (both residents and faculty). However, we DO NOT bill for them. I don't think they are recognized by Mcare as a "qualified provider" in reference to billing incident-to.

    Hope this helps

    Tammy Frazier, CPC, CPCO, CPMA, CEMC

Similar Threads

  1. Billing for PharmD providing services in FP
    By TWILL11 in forum Family Practice
    Replies: 0
    Last Post: 03-18-2014, 11:38 AM
  2. Billing 92950 in Physician Office
    By lbpeterson in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 08-09-2012, 11:43 AM
  3. Physician billing an Office Visit ...
    By searchthweb in forum Billing/Reimbursement
    Replies: 7
    Last Post: 03-24-2011, 11:38 AM
  4. Billing for the infusion suite in a physician's office
    By lintvedta in forum Billing/Reimbursement
    Replies: 0
    Last Post: 12-15-2010, 01:47 PM
  5. Adenosine Physician Office Billing
    By sowmya in forum Cardiology
    Replies: 0
    Last Post: 10-23-2009, 12:48 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.