Pharmacists as nonphysician practitioners


Fam Pract Manag. 2007 Jan;14(1):11.

We read “How to Bill for Services Performed by Nonphysician Practitioners” [May 2006] by Betsy Nicoletti with great interest. We would respectfully suggest the addition of pharmacists to her list of nonphysician practitioners. The services provided by pharmacists are eligible for incident-to reimbursement along with those of other nonphysician practitioners who work in compliance with the incident-to guidelines.

Pharmacists have a strong medication and disease management education, and a growing number also complete one or two years of postgraduate residency training. This education and training puts pharmacists in a unique position to enhance patient care in a family medicine practice. Pharmacists have long been established practitioners in academic outpatient clinics. A number of studies in the medical literature provide evidence demonstrating the clinical improvement that a pharmacist can bring to the primary care team.1,2

Interest in the use of pharmacists is growing. The Medicare Payment Advisory Commission recognized pharmacists as nonphysician practitioners and discussed reimbursement issues in depth in a June 2002 report to Congress.3 In the near future, Medicare Part D Medication Therapy Management Programs and new CPT codes for pharmacists' services (e.g., 0115T) will provide additional reimbursement opportunities that should facilitate collaboration between pharmacists and family physicians.

As the population ages and chronic care and medication choices become more complex, working closely with pharmacists becomes more useful to overburdened physicians. When changes in billing and reimbursement for pharmacists' services catch up with clinical practice, you will see more practices taking advantage of this beneficial collaboration.


1. Garrett DG, Bluml BM. Patient self-management program for diabetes: first-year clinical, humanistic, and economic outcomes. J Am Pharm Assoc. March/April2005;45:130–137.

2. Lee JL, Grace KA, Taylor AJ. Effect of a pharmacy care program on medication adherence and persistence, blood pressure, and low-density lipoprotein cholesterol: a randomized controlled trial. JAMA. 2006;296:2563–2571.

3. Medicare Payment Advisory Commission. Report to the Congress: Medicare Coverage of Nonphysician Practitioners. June 2002. Available at: http://www.medpac.gov/publications/congressional_reports/jun02_NonPhysCoverage.pdf. Accessed Dec. 11, 2006.


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