FREE BCACP Ambulatory Practice Business Models Questions and Answers

Question 1

An ambulatory care pharmacist works in a physician's office and provides follow-up visits for established patients with hypertension.
To bill for these services as "incident-to" the physician under Medicare Part B, which of the following conditions is required?

Accepted Answer

The physician must be physically present in the office suite when the pharmacist provides the service.

Answer

The physician must co-sign every pharmacist-written note within 24 hours.

Answer

The pharmacist must have their own unique provider transaction access number (PTAN).

Answer

The patient must be seeing the pharmacist for the initial visit to establish the plan of care.

Question 2

An ambulatory care practice is transitioning from a fee-for-service to a value-based care model. Which of the following key performance indicators (KPIs) would be most important to track to demonstrate the practice's success under the new model?

Accepted Answer

Reduction in 30-day hospital readmission rates for managed patients.

Answer

Increase in the total number of patient visits per month.

Answer

Maximization of revenue generated from ancillary services.

Answer

Decrease in the average length of a patient appointment.

Question 3

A pharmacist in a primary care clinic spends 25 minutes during a calendar month providing non-face-to-face care coordination for a Medicare patient with type 2 diabetes and heart failure. This includes telephone calls and medication reconciliation. Which CPT® code is the most appropriate to bill for these services?

Accepted Answer

99490 (Chronic Care Management, First 20 min)

Answer

99211 (Level 1 E/M Office Visit)

Answer

99605 (MTM Service, Initial)

Answer

99491 (CCM, 30 min by Physician/QHP)

Question 4

When presenting a business plan to hospital administration to justify the creation of a new pharmacist-led transitional care management (TCM) service, which of the following provides the strongest argument for a positive return on investment (ROI)?

Accepted Answer

Demonstrated cost avoidance through a reduction in preventable hospital readmissions.

Answer

Projected number of patients enrolled in the first year.

Answer

High patient satisfaction scores reported on post-discharge surveys.

Answer

The number of medication discrepancies identified and resolved by the pharmacist.

Question 5

A 75-year-old patient is discharged from the hospital on a Thursday following an admission for a COPD exacerbation. To meet the requirements for billing Transitional Care Management (TCM) services, the ambulatory care pharmacist must make initial interactive contact (e.g., by telephone) with the patient or caregiver no later than when?

Accepted Answer

The following Monday.

Answer

Within 7 calendar days of discharge.

Answer

At the time of the face-to-face visit.

Answer

The same day as discharge.

Question 6

Which of the following is a mandatory component that defines the scope of a pharmacist's authority within a collaborative practice agreement (CPA)?

Accepted Answer

The specific drug therapy management functions the pharmacist is authorized to perform.

Answer

A formulary of preferred medications the pharmacist must use.

Answer

The fee schedule for services provided by the pharmacist.

Answer

A list of the pharmacist's professional liability insurance policy details.

An ambulatory care pharmacist works in a physician's office and provides follow-up visits for established patients with hypertension.To bill for these services as "incident-to" the physician under Medicare Part B, which of the following conditions is required?

An ambulatory care pharmacist works in a physician's office and provides follow-up visits for established patients with hypertension.
To bill for these services as "incident-to" the physician under Medicare Part B, which of the following conditions is required?