Anyone providing and billing for MTM?

[spacecowgirl]

Any of you out there providing MTM or have MTM providers at your practice sites? My residency site had a very successful MTM practice (6.5 FTE) and now I am trying to get it started at my clinic, but I'm running into so many obstacles with billing/reimbursement. I would love to hear from anyone that is having success with MTM. We know it will never be a revenue-generating service, but we're trying to approach it from the big picture, prevention point of view.



And yes, I know the reimbursement structure is crappy and I know all the other downfalls of MTM. We don't need to discuss that here; thanks in advance.

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[johnep34]

Sorry for just being an ignorant limey. MTM is?
johnep

 

[Farmercyst]

We've been signed up for MTM with Humana for a few years apparently, but they just started sending us some patients. It was hard to bill for through PDX be we ended up getting $15/.25 hours if I remember right.

 

[MountainPharmD]

Sorry for just being an ignorant limey. MTM is?
johnep

Medication Therapy Management. It is getting insurance companies to pay you for counseling and managing a patients medications.

 

[BanBidil]

Any of you out there providing MTM or have MTM providers at your practice sites? My residency site had a very successful MTM practice (6.5 FTE) and now I am trying to get it started at my clinic, but I'm running into so many obstacles with billing/reimbursement. I would love to hear from anyone that is having success with MTM. We know it will never be a revenue-generating service, but we're trying to approach it from the big picture, prevention point of view.



And yes, I know the reimbursement structure is crappy and I know all the other downfalls of MTM. We don't need to discuss that here; thanks in advance.

Still working on it....but good post.

 

[Sparda29]

My last site had something like that set up, but it was a very small operation.

 

[spacecowgirl]

I think I'm starting to make some progress. Of course different insurance companies have to be difficult with billing (screw you Humana and Medica!) differently but I'm feeling more optimistic now than I have in many months.

I'm starting with patients of 4 providers and I have 7 CPAs. Hopefully it will work out well with those providers and I can expand from there.