99605
Medication therapy management, new patient
Initial 15 minutes, face-to-face with the patient, provided by a pharmacist, for a patient new to the service.
CPT Codes
Comprehensive medication management billing codes: 99605, 99606 and 99607
These are the pharmacist medication therapy management codes. They are the billing route for comprehensive medication management, but the code titles describe the narrower service.
99606
Medication therapy management, established patient
Initial 15 minutes, face-to-face with the patient, provided by a pharmacist, for an established patient.
99607
Each additional 15 minutes
Reported with 99605 or 99606 for each further 15 minutes in the same encounter.
Name and Service
Why do the code titles say medication therapy management?
Because that is what the AMA descriptors say. These codes title medication therapy management services provided by a pharmacist, and they are the billing route most often used for comprehensive medication management.
The two are not the same service. Medication therapy management is a defined Medicare Part D program requirement with eligibility criteria set by the plan. Comprehensive medication management is a standard of clinical practice: a structured assessment of whether every medication a patient takes is appropriate, effective, safe and able to be taken as intended, continuing through follow-up until problems are resolved.
Stating this plainly matters more than it might appear. A reader who takes the code title as a description of the service will conclude the two are interchangeable, and they are not. The codes are the reimbursement mechanism; they do not define the clinical work.
Structure
How is the time counted?
In 15 minute increments within an encounter, rather than across a calendar month. This is a different structure from the care management codes, which accumulate time monthly.
99605 and 99606 differ only in whether the patient is new to the service or established. Both cover the initial 15 minutes. 99607 is the add-on for each further 15 minutes in the same encounter.
The descriptors describe a face-to-face service, so the reimbursement route constrains the delivery mode in a way the clinical service itself does not. A program delivering medication management remotely needs to establish how it will be reimbursed before it designs the workflow around it.
Common Questions
Related questions
Are 99605, 99606 and 99607 comprehensive medication management codes?
They are the codes most often used to bill it, but their AMA descriptors title medication therapy management services provided by a pharmacist. Comprehensive medication management is the broader clinical service. The code titles describe the narrower one.
What is the difference between 99605 and 99606?
Only whether the patient is new to the service or established. Both cover the initial 15 minutes of a face-to-face medication therapy management service provided by a pharmacist.
Does comprehensive medication management require a pharmacist?
In nearly every implementation, yes. The assessment of whether a regimen is appropriate, effective, safe and takeable rests on pharmacist clinical judgment. What the pharmacist may change without a new order depends on state law and on whether a collaborative practice agreement is in place.
Can the service be delivered remotely?
The clinical service can. The code descriptors describe a face-to-face service, so the reimbursement route is the constraint rather than the clinical work. Establish the billing pathway before designing a remote workflow around it.
Is medication therapy management the same as comprehensive medication management?
No. Medication therapy management is a Medicare Part D program requirement with plan-set eligibility criteria. Comprehensive medication management is a practice standard that continues through follow-up to resolution. They overlap in activity but differ in scope, trigger and endpoint.
Code descriptors reflect the AMA CPT code set and the CMS HCPCS code set current as of CY2026. Both are revised annually, and Medicare Administrative Contractor and commercial payer policy varies. This page describes what each code covers and the conditions attached to reporting it. It is a reference, not billing advice for a specific claim, and it carries no payment rates.
Related reading
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