The Benefit- Improve Patient Compliance

Comprehensive Medication Management (CMM) sessions, facilitated by clinical pharmacists, are intended to maximize therapeutic effectiveness, minimize medication-related adverse events, and reduce errors. These sessions are billed under the physician's NPI through incident-to billing, utilizing evaluation and management (E/M) codes 99212-99215. They can be conducted in person or via telehealth. Prime Clinical Associates arranges these appointments with your patients based on factors such as disease state, prescription count, patient complexity, and provider referral. Additionally, our scheduling system aims to avoid overlapping these visits with any E/M sessions previously scheduled in the same month. 

Patients derive significant benefits from these visits as they gain a deeper understanding of their medications and health conditions, resulting in enhanced compliance and outcomes. Moreover, they have an opportunity to express any concerns regarding prescription costs, dosing regimens, or adverse effects.

Providers also reap numerous advantages from these encounters. They receive expert advice and recommendations from clinical pharmacists regarding medication appropriateness based on patient assessments. Additionally, having an updated medication reconciliation within the patient's chart streamlines the provider's decision-making process, eliminating the need to investigate whether a patient is using multiple prescriptions, over-the-counter medications, or herbal products.

The majority of our Comprehensive Medication Management (CMM) encounters are billed using E/M code 99214, determined by the duration of the visit. We do not utilize medical decision-making criteria for billing purposes. All recommendations provided to both the patient and the provider are documented within the note. To ensure clarity and consistency, we adhere to the E/M billing guidelines set forth by the American Medical Association. Our recommendations are primarily evidence-based, with additional insights drawn from clinical experience.