G10 - MTMS update 2-15

G10 - MTMS update 2-15 - The three MTM reimbursement codes...

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The three MTM reimbursement codes – Just what is the average payments pharmacists are receiving for each Whitney Dickson Chirag Jhatakia Kiranpreet Kaur Khanh Nguyen Kim Yeung
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Background What is MTM? Face-to-face patient assessment and intervention by a pharmacist Introduced by congress in the Medicare Modernization Act of 2003 Required that each Medicare Part D plan provider offer an MTM program to specific beneficiaries beginning in 2006 Pharmacists bill for reimbursement through CPT (current procedural terminology) codes
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CPT Codes Codes are not descriptive and are time-based Make it easier for pharmacists to bill for service Create a standard nomenclature for communication between health care providers and health payers Initially approved as Category 3 – “emerging technology” or “tracking”codes Reclassified as Category 1 in Jan 2008 -this changed the status of pharmacist MTM codes to recognized standard of care What are the CPT codes? 99605: used for first-encounter service (up to 15 min)
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G10 - MTMS update 2-15 - The three MTM reimbursement codes...

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