Wiki Clinical Pharmacist Billing

[jgrahamtaylor]

How to bill Clinical Pharmacist E&M services incident to a physician or APP. Can they bill 99211 for example and does Medicaid/Medicare pay for the incident services.

 

[thomas7331]

Yes, a pharmacist can bill 99211 under the provider's credentials, but keep in mind that all of the 'incident to' requirements must be met: the pharmacist must be an employee or contractor of that provider and working under their direct supervision, and the services that the pharmacists are performing must be those that were ordered by the provider as a part of their plan of care for the patient. If the pharmacist is practicing independently, then the service would not qualify for 'incident to' billing.

Medicare will reimburse 99211 if these requirements are met. For Medicaid, you would need to contact your area's plans as the requirements and regulations may vary from state to state.