Official websites use. Share sensitive information only on official, secure websites. This work was not supported by any funding source. The authors have no relevant conflicts of interest to disclose. The inclusion of pharmacists on care teams has been shown to improve clinical and economic health outcomes. However, a significant barrier to the widespread incorporation of pharmacists into care teams is the ability to financially support the salary of the pharmacist. A mechanism to improve the ability of pharmacists to generate clinical revenue already exists in the form of incident-to billing, although there remains considerable uncertainty regarding the criteria for incident-to billing and specifically how pharmacists can use this model to capture revenue for clinical services.
In this article, we discuss incident-to billing criteria as it pertains to outpatient clinics, common misconceptions related to incident-to billing, and how clinical pharmacists may use this mechanism to generate revenue for the clinical services they provide.
Pharmacists are playing increasingly larger roles in the outpatient setting by working with physicians and patients to provide medication management services for numerous chronic disease states. The benefits of this collaborative relationship, often called physician-pharmacist collaborative management PPCM , are well documented for chronic disease states, namely hypertension and diabetes, with improvements in attainment of goal blood pressure, hemoglobin A1c, and cholesterol markers.
Despite the benefits of PPCM, widespread integration of pharmacists into care teams remains limited, most notably due to financial barriers. Because of the lack of national provider status, pharmacists have not been able to directly bill for their services at a level commensurate with their knowledge and skills.
This financial barrier effectively limits the ability to financially sustain a collaborative model with other health care providers to improve patient outcomes and patient access to high quality health care.
