Reimbursement outcomes of a pharmacist‐physician co‐visit model in a Federally Qualified Health Center

Background Pharmacists have demonstrated a positive impact in providing patient care in ambulatory settings. Pharmacists have faced multiple barriers to reimbursement, especially in a Federally Qualified Health Center (FQHC) setting. A commonly cited barrier is lack of recognition as providers under Medicare. Objectives The objective of this study was to describe the reimbursement potential, physician appointment capacity, and billing levels with the use of a pharmacist‐physician co‐visit model in an urban FQHC. Methods This was a retrospective, observational cohort study. Patient visits were included in the co‐visit model cohort if they were completed with the pharmacist and/or collaborating physician on the same clinic half‐day from May‐September 2019. Comparator group patient visits were included in the physician‐only cohort if they were with one of five physicians practicing at the FQHC on a day without the pharmacist. Patient visits were excluded if the visit was nonbillable. Results Realized reimbursement per half‐day in clinic [mean (SD)], was significantly less with the physician‐only visits compared to the co‐visit billing model [$558 (242) vs $850 (410), P = .001]. The addition of a pharmacist through the co‐visit billing model increased the median (IQR) billing per half‐day in clinic from $1613 (1173, 1788) to $2108 (1832,2620) (P