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Medication Therapy Management

December 2013


A single medication therapy management follow-up encounter may be authorized if: 

  • Recipient has been diagnosed with a new chronic condition since the last encounter that requires treatment with 2 or more new medications OR 
  • Recipient’s current condition(s) has changed or worsened requiring a change or addition of 3 or more medications AND
  • Patient has eight or more paid encounters in the last 365 days 
  • Patient has communicated to the pharmacist significant problems with the new drug regimen and intervention is necessary to prevent possible hospitalization or emergency room visit
  • Patient has a history of medication compliance 
  • Patient's past MTM encounters have resulted in documented positive outcomes 

Pharmacy unit must receive (Fax # 651-431-7426) 

  • Patient MHCP ID number 
  • Patient’s new diagnosis or description of the changes in the patient’s condition(s) 
  • List of new medications since last encounter 
  • List of changed medications since last encounter 
  • List of new problems presented by the new drug regimen 
  • Expected outcomes of encounter 
  • Documentation of all encounters in last 365 days 
  • Date of next MTM encounter 
  • Treating pharmacist name and provider number
  • Clinic or pharmacy “pay to” provider number 
  • Treating pharmacist phone number 


MHCP Provider Call Center 651-431-2700 or 800-366-5411

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