Medication reconciliation reimbursement increases to $35 for Medicare Advantage members

When medication reconciliation is conducted within 30 days of a hospital discharge and a claim is submitted for CPT II code *1111F, Blue Cross Blue Shield of Michigan will reimburse providers $35 for its Medicare Advantage products: Medicare Plus Blue^SM and BCN Advantage^SM. Blue Cross commercial continues to reimburse at $35.

Medication Reconciliation Post-Discharge is a HEDIS^® measure.**

To receive reimbursement, follow these steps when patients are discharged after a hospital stay:

• Schedule a medication reconciliation as soon as possible.
• Perform medication reconciliation by comparing the hospital discharge medications against the patient’s current list of medications.
• Physicians, physician assistants, pharmacists, registered nurses and nurse practitioners may conduct a medication reconciliation.
• One example of acceptable documentation in the outpatient medical record is Current and discharge medications were reconciled.
• Submit *1111F with the post-discharge office visit claim within 30 days of the discharge. The code description is Discharge medications reconciled with the current medication list in outpatient medical record.

About the HEDIS measure
Medication Reconciliation Post-Discharge assesses patients age 18 and older in the measurement year who were discharged from an acute or non-acute inpatient stay between Jan. 1 and Dec. 1 of the measurement year. It looks at patients whose medications were reconciled from the date of discharge through 30 days after discharge (31 days total).

Click here to review the Medication Reconciliation Post-Discharge tip sheet.

**HEDIS^® is a registered trademark of the National Committee for Quality Assurance.