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Pharmacist Service Can Be Considered 'Incident to' Service

Communication with CMS confirms AAFP view of incident to services relating to pharmacists

TUESDAY, April 29, 2014 (HealthDay News) -- Physicians may bill for pharmacist services as part of the "incident to" services provided to Medicare patients, according to communication between the American Academy of Family Physicians (AAFP) and the Centers for Medicare & Medicaid Services (CMS).

The incident to rule allows a physician to bill for some health care services provided by practice staff members, as long as these are part of an established patient care plan. Kent Moore, the AAFP's senior strategist for physician payment sought to clarify this in relation to pharmacists employed by the physician's practice.

In a letter to CMS administrator Marilyn Tavenner, Moore addressed the issue of pharmacists having and documenting direct face-to-face encounters with patients. In section 60 of the Medicare Benefit Policy Manual, there is nothing to exclude pharmacists from this definition, and consequently Moore wanted to clarify this interpretation, assuming incident to rules were otherwise met.

"In your letter, you ask that we confirm your impression that if all the requirements of the 'incident to' statute and regulations are met, a physician may bill for services provided by a pharmacist as incident to services," Tavenner wrote in response, according to Moore. "We agree."

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