Intense lobbying by the American Medical Association (AMA) and related professional organizations led to significant changes to requirements for documentation of outpatient clinical services. As of 2021, providers are now free to choose between either time or medical decision-making (MDM) when “leveling” such services. Despite this change, many providers and clinical pharmacists may not yet realize its full billing implications. This article discusses why these billing changes occurred, what those changes actually mean in clinical practice, and how the three factors used to determine MDM can be utilized by clinical pharmacists in daily practice. Finally, a brief introduction to other potential billing codes open to pharmacists and discussion of MDM documentation requirements is included.

美国医学协会 (AMA) 和相关专业组织的激烈游说导致门诊临床服务文件要求发生重大变化。截至 2021 年，提供者现在可以在“平衡”此类服务时在时间或医疗决策 (MDM) 之间自由选择。尽管发生了这种变化，但许多供应商和临床药剂师可能尚未意识到其全部计费影响。本文讨论了为什么会发生这些计费变化，这些变化在临床实践中的实际含义，以及临床药剂师如何在日常实践中利用用于确定 MDM 的三个因素。最后，简要介绍了对药剂师开放的其他潜在计费代码，并讨论了 MDM 文档要求。