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Permanent CPT codes approved for MTM services
Codes enhance professional services for patients
The Pharmacist Services Technical Advisory Coalition (PSTAC) has obtained approval for permanent CPT codes for billing pharmacists' medication therapy management (MTM) services. Pharmacist leaders say having the codes will expand pharmacists' ability to provide professional services to their patients.
CPT (Current Procedure Terminology) codes are approved by the American Medical Association as the nomenclature used by the health care industry to report professional services, laboratory tests, and medical procedures in health care claims. The new pharmacist codes, making permanent temporary codes that had been assigned, have new numbers and took effect January 1.
The new codes are:
• Medication Therapy Management Service(s) (MTMS): describe face-to-face patient assessment and intervention as appropriate, by a pharmacist, upon request. MTMS is provided to optimize the response to medications or to manage treatment-related medication interactions or complications.
MTMS includes the following documented elements: review of the pertinent patient history, medication profile (prescription and nonprescription), and recommendations for improving health outcomes and treatment compliance. These codes are not to be used to describe the provision of product-specific information at the point of dispensing or any other routine dispensing-related activities.
99605: Medication therapy management service(s) provided by a pharmacist, individual, face-to-face with patient, with assessment and intervention if provided; initial 15 minutes, new patient.
99606: Initial 15 minutes, established patient.
99607: Each additional 15 minutes (list separately in addition to code for primary service).
PSTAC is a coalition of seven national pharmacy organizations including the American College of Clinical Pharmacy, the Academy of Managed Care Pharmacy, the American Pharmacists Association, the American Society of Consultant Pharmacists, the American Society of Health-system Pharmacists, the National Association of Chain Drug Stores, and the National Community Pharmacists Association.
The coalition has been successful at integrating pharmacists and their professional services into the traditional medical services billing model. PSTAC provides the national leadership necessary to secure pharmacy's position in the national electronic data interchange environment related to health encounter/claims processing and payment of pharmacist professional services.