CPT® code 99606 is used to report a medication therapy management (MTM) service provided by a pharmacist in a face-to-face setting with a patient, lasting approximately 15 minutes. This service focuses on optimizing therapeutic outcomes through comprehensive medication review and patient counseling.
What is CPT Code 99606?
CPT 99606 describes an initial MTM session where a pharmacist evaluates the patient’s entire medication regimen, including prescription, over-the-counter, herbal, and dietary supplements. The goal is to identify, resolve, and prevent medication-related problems and improve adherence.
Typical components include:
- Reviewing all current medications for appropriateness, effectiveness, and safety
- Assessing medication adherence and barriers to compliance
- Identifying potential drug interactions or duplications
- Providing education and counseling about proper medication use
- Coordinating with prescribing providers to optimize therapy
This service is essential in managing chronic conditions and minimizing adverse drug events, especially in patients with complex or multiple medication regimens.
When to Use CPT Code 99606
Use CPT 99606 for the initial face-to-face MTM session lasting 15 minutes. Subsequent sessions lasting 15 minutes are reported with CPT 99607.
Documentation should include:
- The medications reviewed and any changes made or recommended
- Patient’s understanding and compliance
- Discussion of potential side effects or drug interactions
- Communication with other healthcare providers as needed
Coding Considerations
- MTM services are typically delivered by pharmacists but may be reimbursed under certain health plans or Medicare Part D.
- Time-based coding requires careful documentation of face-to-face time spent with the patient.
- MTM codes (99605, 99606, 99607) are distinct from traditional E/M services and are focused solely on medication management.
- Ensure billing aligns with payer-specific policies regarding pharmacist-provided services.
CPT 99606 and Comprehensive Medication Management
Medication therapy management is critical in improving patient safety, reducing hospitalizations, and enhancing clinical outcomes. Pharmacist-led MTM programs are increasingly recognized for their role in value-based care models.
Providers should maintain detailed notes demonstrating the scope of the medication review, patient education, and follow-up plans to support medical necessity and reimbursement.
Optimize Medication Management with OptiMantra
For practices integrating pharmacist-led MTM services or incorporating medication reviews into patient care, OptiMantra offers powerful tools to:
- Document MTM encounters with customizable templates
- Track medication lists and changes in real time
- Link MTM sessions directly to patient records and care plans
- Generate accurate CPT-coded superbills for MTM billing
- Streamline communication between pharmacists and providers within one platform
With OptiMantra, medication management becomes more efficient and compliant—helping your team deliver safer, more coordinated care while maximizing reimbursement opportunities.
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