What are MTM CPT codes?

Three pharmacist-specific Current Procedural Terminology (CPT) codes exist to facilitate medication therapy management (MTM) reimbursement (codes 99605, 99606, and 99607). Large databases that contain these codes provide an opportunity to assess the effectiveness of MTM services.

What part does Medicare cover MTM?

Part D
In 2019, there are 649 Part D contracts with an approved MTM program. – 543 Medicare Advantage prescription drug plans (MA-PDs). – 60 stand-alone prescription drug plans (PDPs), including Employer contract MTM programs. – 46 Medicare-Medicaid Plans (MMPs).

Which document in MTM is a comprehensive medication record of the patient’s prescription and nonprescription medications?

Personal Medication Record: The personal medication record (PMR) is a comprehensive record of the patient’s medications (prescription and nonprescription medications, herbal products, and other dietary supplements).

What is the CPT code for pharmacy?

CPT code 99091: may only be used by physicians or other qualified health care professionals authorized to independently bill Medicare for services….Pharmacists’ Scope of Practice.

Service Applicable CPT Codes
E/M established patient 99211, 99212-99215
E/M new patient 99202-99205

Do pharmacy claims have CPT codes?

The CPT codes that are used to report Pharmacy services are 99605 CPT Code, 99606 CPT Code & 99607 CPT Code.

Which individual S may provide MTM services based on federal law?

CMS requires MTM plan sponsors to submit information about the MTM program each year, and plan sponsors must indicate which types of providers deliver MTM services within their plan by selecting one or more of the following provider types: Local pharmacist. Long-term care consultant pharmacist. Plan sponsor pharmacist.

What is MTM CMS?

Requirements for Medication Therapy Management (MTM) Programs: Under 423.153(d), a Part D sponsor must have established a MTM program that: Ensures optimum therapeutic outcomes for targeted beneficiaries through improved medication use. Reduces the risk of adverse events.

What is the map portion of a medication therapy review MTM )?

What is a Medication-related Action Plan (MAP)? This is the care plan developed by your pharmacist after discussing your medications in an MTM session or shorter MTR session. A MAP includes items that you and the pharmacist can complete without working with a doctor or other health care professional.

What is a factor when determining a patient’s eligibility for MTM?

The Patient Protection and Affordable Care Act (PPACA) laid out a set of MTM eligibility criteria for eligible entities to target patients for MTM services: “(1) take 4 or more prescribed medications …; (2) take any ‘high risk’ medications; (3) have 2 or more chronic diseases… or (4) have undergone a transition of care …