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CMMC Enrollment Form

PPA Comprehensive Medication Management Collaborative (CMMC)

Complete the form below to join the CMMC. Filling out the form is step one; after completing this form, you will be directed to a page to pay for your enrollment.  To be considered an approved enrollee and receive the code to access the training, you need to complete both steps.  Please direct any inquiries to ppcntrainer@papharmacists.com.

 

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Patient Care Services Provided:

Comprehensive Medication Review (CMR)

Definition: A CMS required Medication Therapy Management (MTM) service that is a systematic process of collecting patient-specific information, assessing medication therapies to identify medication-related problems, developing a prioritized list of medication-related problems, and creating a plan to resolve them with the patient, caregiver, and/or prescriber. (Example:  CMR conducted via contract with OutcomesMTM, Mirixa, or other MTM vendor)

 

Select the volume per week that most closely reflects your average number of patient encounters at your primary site where you see patients:






Targeted Medication Review (TMR)

Definition: A CMS required MTM service provided that addresses specific or potential medication-related problems which may result in a follow-up intervention with a patient and/or prescriber.  (Example:  Targeted interventions conducted via contract with OutcomesMTM, Mirixa, Socrxates, or other MTM vendor)

 

Select the volume per week that most closely reflects your average number of patient encounters at your primary site where you see patients:






Immunizations

Definition: Pharmacy-based immunization delivery via prescription order and/or per written protocol approved by a physician or other authorized medical staff of an institution

 

Select the volume per week that most closely reflects your average number of patient encounters at your primary site where you see patients:






Formal Diabetes Education Program

Definition:  Potential billable service for individually and/or group sessions to provide diabetes education and/or drug therapy and disease-state management.  (Example:  As part of a Diabetes Self-Management Education/Training Program)

 

Select the volume per week that most closely reflects your average number of patient encounters at your primary site where you see patients:






Formal Smoking Cessation Program

Definition: Potential billable service for initial assessment and/or follow up with individuals to provide smoking cessation education and/or drug therapy and disease-state

 

Select the volume per week that most closely reflects your average number of patient encounters at your primary site where you see patients:






Transitional Care Management (TCM)/Transitions of Care

Definition: Performing direct patient care as part of a potentially billable service when a patient leaves one care setting (hospital, nursing home, assisted living facility, SNF, primary care physician, home health, or specialist) and moves to another

 

Select the volume per week that most closely reflects your average number of patient encounters at your primary site where you see patients:






Chronic Care Management (CCM)

Definition:  Performing services directed by a physician, or other qualified health care professional, recognized by CMS and billable under CPT code 99490.

 

Select the volume per week that most closely reflects your average number of patient encounters at your primary site where you see patients:






Medication Management

Definition:  General, potentially non-billable standard of care that ensures patient’s medications are assessed to determine that medication is appropriate, effective, safe, and able to be taken by the patient as intended.  This includes an individualized care plan that achieves the intended goals of therapy with appropriate follow-up to determine actual patient outcomes as well as communication with the patient's health care team.

 

Select the volume per week that most closely reflects your average number of patient encounters at your primary site where you see patients:






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