Wiki Billing for a PharmD in physician office

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cmcgarry

cmcgarry

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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.

Thanks,
 
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
 
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
 
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