Wiki Pharmacist Billing

[kyannekis]

Does anyone know where I can find out information on what documentation rules etc are required when billing for a pharmacists time when working in a provider office for time spent managing medication doses etc under supervision of patients PCP.

 

[ntreber]

I would be interested in this information also as well as code sets being billed.

 

[thomas7331]

Pharmacists are not eligible to enroll or bill independently under CMS/Medicare rules, so I believe that any services performed by a pharmacist would have to be treated the same as any other ancillary staff services and strictly meet the requirements for services performed 'incident to' a physician's plan of care. I don't know of any private payers that credential pharmacists either.

'Incident to' is an unusual arrangement for someone trained in this profession and not the routine way that pharmacists normally practice. If you are going to bill for pharmacists' services under a physician's credentials, I'd recommend a high degree caution, and also having your practice's compliance department closely involved. A practice I worked with a number of years ago doing exactly this had to pay a very large fine to Medicare for inappropriate billing.