Description: Discharge medications reconciled with the current medication list in the outpatient medical record within 30 days of appropriate discharge.
Delivery Method: Face-to-Face, Phone and/or Video
Who can bill? A licensed care-team member or unlicensed care team member if signed off by acceptable practitioner.
Recommended Documentation:
- Date performed
- Current Medication list
- Evidence that clinician is aware of hospitalization and discharge
- Notation that the clinician reconciled the current and discharge medications
- Notation that both lists were reviewed on the same day
- Notation that references the discharge medications (Ex: No change in medications since discharge, discontinuation of medications
- Notation that no medications were prescribed upon discharge.
Reference Materials
- 2023 Star Measure Tip Sheet – Medication Reconciliation Post Discharge
- BCBSM - 2023 Transition of Care HEDIS Measure Education
- Medications at Transitions and Clinical Handoffs (MATCH) Toolkit for Medication Reconciliation
- Utilizing Medical Assistants to the Top of their Training
1111F Med Rec FAQ’s
Q: Is a face-to-face visit required to bill the 1111F?
A: No, evidence of a medication reconciliation must be documented within medical record only.
Q: What training is required for them to bill this code?
A: It's highly encouraged to complete Introduction to Team-Based Care within 6 months of starting to bill.
Q: Can an unlicensed care-team member (medical assistant) perform a medication reconciliation?
A: Yes, if signed off by a prescribing practitioner, clinical pharmacist, or physician assistant .
Q: Can 1111F be billed simultaneously to the PDCM codes?
A: Yes, can be billed within the same encounter
Q: Can the 1111F be billed alone or with an associated visit?
A: Both