Medication Therapy Management: Pharmacy Tech's Role in MTM

What Is Medication Therapy Management?

Medication therapy management (MTM) is a set of clinical services provided by pharmacists to optimize medication use, improve therapeutic outcomes, and reduce the risk of adverse drug events. MTM services include comprehensive medication reviews, targeted interventions for specific drug therapy problems, and patient education. While pharmacists are the primary providers of MTM services, pharmacy technicians play an increasingly important support role in the delivery of these programs.

Why MTM Matters in Healthcare

Medication-related problems are a significant source of preventable illness and healthcare costs. Patients who take multiple medications, especially elderly patients with chronic conditions, are at higher risk for drug interactions, duplicate therapy, non-adherence, and adverse reactions. MTM programs help identify and resolve these issues before they lead to hospitalizations, emergency room visits, or worsening health outcomes.

The Centers for Medicare and Medicaid Services (CMS) requires Medicare Part D plans to offer MTM services to eligible beneficiaries. Many commercial insurance plans and state Medicaid programs also support MTM. This has created a growing demand for MTM services in community pharmacies, health systems, and specialized MTM service providers.

Core MTM Services

• Comprehensive Medication Review (CMR): A thorough review of all medications a patient takes, including prescriptions, over-the-counter drugs, and supplements
• Targeted Medication Review (TMR): A focused review addressing a specific drug therapy problem
• Medication Action Plan (MAP): A patient-friendly document outlining recommended actions for optimal medication use
• Personal Medication Record (PMR): A comprehensive list of all medications the patient takes, including doses and directions
• Intervention and referral: Communicating with prescribers to resolve identified issues

The Pharmacy Technician's Role in MTM

Pharmacy technicians support MTM services in several important ways. While the clinical assessment and counseling must be performed by the pharmacist, technicians handle much of the administrative and logistical work that makes MTM programs efficient and effective.

Key Technician Responsibilities

• Identifying patients who are eligible for MTM services based on insurance criteria
• Scheduling MTM appointments and sending reminders to patients
• Collecting and organizing patient medication lists before the pharmacist's review
• Preparing the personal medication record (PMR) for the pharmacist to verify
• Entering data into MTM documentation platforms such as OutcomesMTM or Mirixa
• Following up with patients after their MTM consultation to check on progress
• Tracking completion rates and billing for MTM services

Patient Eligibility for MTM

Medicare Part D MTM eligibility is determined by each plan's criteria, but CMS establishes minimum thresholds. Generally, patients qualify for MTM if they have multiple chronic conditions (such as diabetes, heart failure, hypertension, or high cholesterol), take multiple Part D medications, and are likely to incur annual medication costs above a specified threshold. Pharmacy technicians can help identify these patients by running reports in the pharmacy management system.

Eligible patients are contacted and invited to participate in a comprehensive medication review with the pharmacist. The technician's role in reaching out to patients, explaining the program, and scheduling the appointment is crucial for program participation rates.

MTM Documentation and Billing

Proper documentation is essential for MTM services. Each encounter must be documented with details about the medications reviewed, problems identified, interventions recommended, and outcomes achieved. This documentation serves as the clinical record and supports billing for the services provided.

Pharmacy technicians often handle the billing and claims submission for MTM services. Understanding the relevant CPT codes and billing requirements ensures that the pharmacy receives appropriate reimbursement. The most common MTM billing codes include 99605 and 99606 for initial and additional 15-minute increments of pharmacist-provided MTM services.

MTM Technology Platforms

Several technology platforms support MTM service delivery. OutcomesMTM is one of the largest platforms used by community pharmacies, connecting pharmacies with payers and patients for MTM opportunities. Mirixa, now part of Outcomes, is another widely used platform. These systems help pharmacies identify eligible patients, document services, and submit claims.

Pharmacy technicians should become proficient with the MTM platform used by their pharmacy. This includes knowing how to navigate the system, enter patient data, generate medication lists, and process claims. Technicians who are skilled with MTM technology are particularly valuable to pharmacy operations.

Communication Skills for MTM Support

Working in MTM requires strong communication skills, especially when contacting patients about the program. Many patients are unfamiliar with MTM and may be skeptical about receiving a call from their pharmacy. Technicians should be prepared to explain the purpose and benefits of MTM in clear, non-technical language. Emphasize that the service is free (covered by their insurance), confidential, and designed to help them get the most benefit from their medications.

When scheduling appointments, be flexible and accommodating. Some patients prefer phone consultations, while others may want to visit the pharmacy in person. Work with the patient to find a time that is convenient and allows the pharmacist adequate time for a thorough review.

Career Opportunities in MTM

The expansion of MTM services has created new career opportunities for pharmacy technicians. Some pharmacies have designated MTM technician positions focused entirely on supporting medication management programs. These roles typically offer higher pay and more regular hours compared to traditional dispensing positions. Technicians with MTM experience may also find opportunities with MTM service companies, health plans, and healthcare consulting firms.

The Future of MTM

MTM is expected to continue growing as healthcare shifts toward value-based care models that reward quality outcomes over volume of services. Pharmacy technicians who develop expertise in MTM support position themselves at the forefront of this expanding area of pharmacy practice. By mastering the administrative, technological, and communication aspects of MTM, technicians contribute meaningfully to improved patient outcomes while advancing their own careers in the pharmacy profession.