Telepharmacy and telemedicine both describe the provision of healthcare services being carried out over two-way real-time interactive audio and video.3 Currently, state Medicaid laws only reimburse for live video diagnostics performed by medical doctors. Since diagnosing is not within a pharmacist’s scope of practice, pharmacy, along with other store-and-forward and patient monitoring services, are usually not reimbursed.4 Medicare also requires that tele-services are ‘live and face-to-face’ to become eligible for reimbursement.5
Even though many telepharmacy services are not yet directly reimbursed, they are becoming increasingly valuable, especially for the healthcare gaps they fill. Telepharmacy order review and verification services are important in locations with limited pharmacy support, and telehealth pharmaceutical care services (e.g., disease state management, CMM, and patient counseling) can bring much needed healthcare support to patients with limited access to care, such as those in remote, rural communities, or those who require frequent monitoring.6
- Health Resources and Services Administration (HRSA), Telehealth Programs. August 2019.
- American Society of Health-System Pharmacists. ASHP statement on telepharmacy. Am J Health-Syst Pharm. 2017; 74:e236-41.
- NC Divison of Medical Assistance, Medicaid and Health Choice Manual, Clinical Coverage Policy No: 1H, Telemedicine and Telepsychiatry. January 2018.
- The Center for Connected Health Policy’s (CCHP). State Telehealth Laws and Reimbursement Policies Report. Fall 2019.
- Centers for Medicare & Medicaid Services (CMS) and Medical Learning Network (MLN). Telehealth Services. January 2019.
- Badowski ME, et al. Pharmacotherapy. 2018 Feb;38(2):e7-e16.