Stories from the front lines of clinical pharmacy.
Operator playbooks, code-level deep dives, and policy primers — written by the pharmacists, billing leads, and operators who do the work every day.
How to bill 99490 cleanly
The most-billed CCM code is also the most-denied. Here's the documentation discipline that turns a 19-minute med-rec call into a clean $65 claim — and the three audit findings we see most.
Blog · OperatorWhat we learned from 50+ MedMe deployments
Patterns we see in the first 90 days of pharmacy clinical-services rollouts — what predicts a high-revenue site, what predicts a stalled rollout, and the four things every operator gets wrong before they get it right.
Blog · PolicyRHTP, explained for community pharmacy
$50B over 5 years. Pharmacy is a named delivery partner in nearly every approved state plan. Here's a community-pharmacy translation of the program — what it is, who's eligible, and what to do this quarter.
Blog · OperatorWhy generic EHRs don't work in pharmacy
We compare the same encounter documented in a generic ambulatory EHR, in a dispensing-system add-on, and in MedMe. The gaps aren't features — they're shape.
Blog · PolicyPharmacist provider status: 2026 update
H.R. 1770 has the most realistic shot at the floor in a decade. Several states (Idaho, Montana, New Mexico, Utah, North Carolina) have moved on state-level legislation. Where things actually stand, and what to do regardless.
Blog · MTMThe commercial MTM contract no one is talking about
Part D MTM is crowded. The bigger margins for most of our customers come from employer / commercial-payer MTM contracts that go through PBMs. Here's what the contract terms look like and how to land one.
Blog · CustomerHeritage Rx: a year-one operator postmortem
An 8-store Pennsylvania independent unlocked $1.4M in clinical-service reimbursement in their first 12 months on MedMe. Their clinical lead walks through the five things they'd do differently if they were starting over.
Blog · BillingThe audit findings the OIG flagged in 2025
The OIG report on pharmacy clinical-services billing dropped in late 2025. Three patterns dominate. We summarize what auditors flagged, what they recommended, and what it means for documentation discipline going forward.
Blog · POCTStrep, flu, and RSV at the counter: the 2026 math
POCT pays — when you have the right CPA, the right paired E/M code, and the supply contracts. We break down per-test economics for the four highest-volume POC tests in pharmacy at 2026 PFS rates.
Blog · OperatorThe pharmacist-as-bottleneck problem
Every clinical-services rollout we see eventually hits the same wall: pharmacist time is the constraint. We walk through the three operator strategies that work — task delegation, AI scribe, and incident-to scope.
Blog · CCMTime-tracking discipline: the $80K-per-store difference
The same patient encounter documented at a 6-store pharmacy can yield $0 or $80K in annual reimbursement, depending entirely on whether you track time in real time. Here's the operator-side fix.
Blog · VaccinesWhy vaccine admin denial rates spiked in late 2025
Three MAC regions tightened supervision posture documentation requirements in Q4 2025. We walk through what changed, who was caught flat-footed, and how to bring vaccine-admin denial rates back under 4%.
Blog · BHIBehavioral health collaborative care, for pharmacists who haven't started
The 2026 PFS expanded the BHI codes pharmacists can bill in collaborative arrangements. The work is medication management — exactly what pharmacists do already. Here's how to start, end-to-end.
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