Analysis of pharmacist charges for medication therapy management services in an outpatient setting

Pharmacist charges for medication therapy management (MTM) services in an outpatient setting were analyzed.

Patients' visits with pharmacists in three ambulatory care clinics in a large, urban teaching institution from December 2005 through February 2006 were analyzed. Data collected included the number and type of current diseases, insurance coverage, number of medications patients were taking, pharmacist time spent per patient visit, pharmacy services provided, and estimated charge for services based on level of care provided using physician and pharmacist billing codes. Data were analyzed using descriptive statistics.

A total of 500 pharmacist-patient visits were evaluated. The mean +/- S.D. patient age was 59.0 +/- 13.3 years. Patients had a mean +/- S.D. of 4.0 +/- 2.0 diseases and were taking 9.1 +/- 4.6 medications. The majority of visits (83%) lasted 30 minutes or less. The mean charge per visit using incident-to physician care billing was $37.09 and $63.24 for level 1 and level 2 visits, respectively. Pharmacist billing was found to result in an average charge of $26.58 ($1 per minute), $53.16 ($2 per minute), or $79.72 ($3 per minute) per visit. There was no difference in pharmacist time spent with complex patients versus noncomplex patients ( p = 0.1314). The use of pharmacist billing codes would not be beneficial unless each visit was billed as $3 per minute.

Converting from incident-to physician billing to pharmacist billing would not generate additional revenue for this medical center at this time.