2025 CPT code 99606
(Active) Effective Date: N/A Medicine Services and Procedures - Medication Therapy Management Services Medicine Feed
Medication therapy management service(s) provided by a pharmacist, individual, face-to-face with patient, with assessment and intervention if provided; initial 15 minutes, established patient.
Medical necessity must be established for MTM services.This typically involves demonstrating that the patient has complex medication regimens, multiple chronic conditions, or difficulty managing their medications, which places them at risk for adverse drug events or suboptimal therapeutic outcomes.
The pharmacist conducts a face-to-face visit with the established patient, reviewing their medical history, creating a medication profile, and making suggestions for improving medication compliance and achieving optimal therapeutic outcomes. Considerations include the patient's medical conditions, complete medication list, cognitive abilities, and caregiver support.The pharmacist's goal is to enhance patient and caregiver understanding of medications, including preventing adverse effects.
In simple words: A pharmacist provides a 15-minute, in-person consultation to an established patient to review their medications and offer advice on how to best manage them. This includes reviewing the patient's medical history, current medications (both prescription and over-the-counter), and providing recommendations to improve their health and medication adherence.
This code describes a 15-minute, face-to-face medication therapy management service provided by a pharmacist to an established patient.It includes assessment and intervention as appropriate, involving a review of the patient's history, medication profile (prescription and nonprescription), and recommendations for improving health outcomes and treatment compliance.
Example 1: A patient with diabetes and hypertension sees their pharmacist for an MTM visit to discuss managing their multiple medications and potential drug interactions., A patient recently discharged from the hospital after a heart attack receives an MTM visit to ensure proper medication understanding and adherence., An elderly patient with multiple chronic conditions and complex medication regimens seeks guidance from their pharmacist during an MTM visit to simplify their medication schedule and minimize adverse events.
Documentation should include the patient's medical history, a comprehensive medication list (including prescription, over-the-counter, and herbal supplements), assessment of medication adherence, identification of any drug-related problems, recommendations for optimizing medication therapy, patient education provided, and the time spent face-to-face with the patient.
- Payment Status: Active
- Specialties:Pharmacy
- Place of Service:Office, Outpatient Hospital, Pharmacy, Home