Collaborative practice

[deleted562805]

Hello fellow Pharmacists. As we all know, many state pharmacy associations are pushing for collaborative practice and some states have collaborative practice. I feel collaborative practice will affect hospital and ambulatory care pharmacy, since now they can bill for services. I get that it is beneficial to pharmacists with residency training and BCPS. But How will collaborative practice affect retail pharmacy? Does collaborative practice agreement benefit only those in hospital and primary care clinics?

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[Pharmacy is a Scam]

Hello fellow Pharmacists. As we all know, many state pharmacy associations are pushing for collaborative practice and some states have collaborative practice. I feel collaborative practice will affect hospital and ambulatory care pharmacy, since now they can bill for services. I get that it is beneficial to pharmacists with residency training and BCPS. But How will collaborative practice affect retail pharmacy? Does collaborative practice agreement benefit only those in hospital and primary care clinics?

Someone has to educate me on what “being able to bill” as a pharmacist actually means, because it is my understanding that there are no billing codes specific to pharmacists so if they were using physician billing codes then this is considered fraud.

Midlevel practitioners such as NPs have their own billing codes that mirror services that a physician can render, however usually the reimbursement for that same service is at 85% of what a physician would get, and there is plenty of fraud going on already with NPs charging MD prices for services by using inappropriate billing codes. Based on this reality, I can’t imagine a pharmacist being able to get away with billing at a physician level, and if they did then I’m sure once insurances catch on they’d lower reimbursement rates for services provided under CPAs from 100% to 85% or lower.

 

[spacecowgirl]

99605-7

 

[Pharmacy is a Scam]

99605-7

So pharmacists are recognized as providers but can’t bill under their own name?

In addition, the billing code for MTM was created by the AMA, not APhA and I can see why. Basically, this is a code for physicians to input that says “a pharmacist provided this service for one of my patients,” which is why pharmacists who want to “bill for services” in reality need to do this under a CPA and they themselves are not the ones submitting the codes.

 

[spacecowgirl]

In my state, they can bill under their own name. That said, it's not always easy for the billing people and payers to understand. Some systems have figured out how to make it sustainable but it's certainly not a revenue generator. Not many primary care functions are, sadly.