How Pharmacies Can Get Paid for Clinical Services They’re Giving Away
You’re Already Doing the Work: How Pharmacies Can Get Paid for Clinical Services They’re Giving Away
If you run an independent pharmacy, you are already doing chronic care management.
You just are not getting paid for most of it.
Every week, your team is checking in on high-risk patients, answering clinical questions, solving adherence issues, and coordinating care with prescribers. Those touchpoints are valuable, clinical, and time-consuming. Under Medicare’s Chronic Care Management (CCM) and Remote Patient Monitoring (RPM) programs, a lot of that work can be structured, documented, and turned into a new, recurring revenue stream.
This blog walks through three simple ideas:
The clinical work you are already doing today
How that work maps to reimbursable CCM and RPM activities
What needs to change to start getting paid for it
Let’s break that down and then walk through rollout, growth planning, and how we help solve these problems.
The Reality: Your Pharmacy Is Already Doing Chronic Care Work For Free
Look at a normal week in your pharmacy. How many of these sound familiar?
Medication sync calls Your team calls patients to align refills, verify changes, and confirm they are still taking their meds.
Adherence and “Where did your meds go?” support Patients call because they forgot to pick up, missed refills, or got confused by a change in dose or manufacturer.
Clinical counseling at the counter and on the phone Your pharmacists explain side effects, dosing, interactions, lifestyle tips, and what to do if something worsens.
Post-discharge check-ins You see a big med list change after a hospital stay and reach out, or the patient calls you first because you are the most accessible.
Informal care coordination You spend time calling prescribers to clarify orders, fix conflicting medications, or request refills on behalf of the patient.
Blood pressure checks and device coaching You help patients use home blood pressure cuffs, glucose meters, or inhalers and answer questions about their readings.
Each of these is a clinical touchpoint for chronic, high-risk patients. In many pharmacies, this work is baked into the culture: “We just take care of our people.” The problem is that it is unstructured, undocumented, and not tied to any formal revenue model.
CCM and RPM give you a way to take the care you already provide and plug it into a Medicare-approved, billable framework in partnership with prescribers.
Connecting the Dots: How Your Current Work Maps to CCM and RPM
Let’s translate your unpaid work into CCM and RPM language.
Who enrolls patients and when?
Chronic Care Management (CCM)
CCM is focused on patients with two or more chronic conditions. It pays physicians (and their partners) for non-face-to-face care coordination and ongoing management each month.
Your current activities that align with CCM:
What happens when a device alert fires?
Medication reconciliation and review after hospital stays
Monthly or quarterly med sync check-ins
Addressing adherence barriers
Reviewing side effects and making recommendations to prescribers
Coordinating refills, prior authorizations, and therapy changes
Educating patients on how to manage their chronic conditions with medications and lifestyle
When that time is organized, tracked, and documented as part of a structured CCM program under a provider’s billing, it becomes billable time instead of “just part of what we do.”
Remote Patient Monitoring (RPM)
RPM focuses on collecting and reviewing physiologic data such as blood pressure, weight, or glucose from patients at home.
Your current activities that align with RPM:
Helping patients select and understand devices
Training patients on how to use home monitors
Answering questions about readings
Flagging worrisome patterns and communicating with providers
Checking in when patients stop using their devices
With RPM, those same actions can support a program where a provider bills monthly for device supply, data collection, and clinical review.
In other words: you are already doing the “guts” of CCM and RPM. The opportunity is to formalize that work inside a compliant, billable structure with physician partners and the right technology.
What Actually Needs to Change To Make It Billable
Turning your existing clinical work into CCM/RPM revenue is less about doing “more” and more about doing it deliberately.
Here are the core changes:
1. Partner with prescribers and define responsibilities
Pharmacies typically do not bill CCM/RPM directly. Instead, they partner with physicians or clinics who bill Medicare and share revenue.
That’s not a workaround—it’s how Medicare envisioned these programs working.
CCM and RPM were designed to support team-based, between-visit care, where the billing provider leads the care plan but works closely with other licensed clinicians and support staff to actually deliver the service.
For many patients, the pharmacy is already:
The most frequent point of contact
The place they ask clinical questions first
The team that sees adherence issues and med changes in real time
From Medicare’s perspective, pharmacies are a natural extension of the care team and an ideal partner for physicians who want to offer CCM/RPM but don’t have the internal staff or workflow to manage it alone.
In practice, you will need to:
Identify provider partners who have high volumes of chronic care patients
Define who does what: patient enrollment, monthly touchpoints, device management, documentation
Clarify how your pharmacy’s clinical work supports the provider’s CCM/RPM billing requirements
Agree on a compliant financial arrangement and expectations for communication
When you position your pharmacy as the clinical engine behind a physician’s CCM/RPM program, you’re not asking for a favor—you’re helping them deliver the kind of coordinated, ongoing care these codes were created to support.
2. Standardize the workflow
Today, your team helps patients “as things come up.” CCM/RPM requires:
Clear criteria for which patients are enrolled
A structured cadence of monthly touchpoints
Defined roles for pharmacists vs. technicians vs. clinical coordinators
Simple scripts and checklists for calls and follow-ups
The goal is not to slow your team down. The goal is to turn chaos into a repeatable service line.
3. Track time and document care
Medicare is paying for time and documented work, not good intentions.
So you need:
A system to log each patient interaction, time spent, and topics covered
A basic care plan that can be updated over time
A way to share notes back to the prescriber’s office
This is where technology matters. Manual spreadsheets and sticky notes will not scale.
4. Use the right CCM/RPM technology stack
Your software should:
Track billable minutes per patient per month
Capture and store call notes and care plans
Integrate with RPM devices when applicable
Provide reports for providers and billers
Be easy enough that your team actually uses it
You do not need the most expensive software on the market. You need something that fits how a pharmacy works, not how a hospital works.
What’s at Stake: Revenue, Differentiation, and Patient Outcomes
When you put a proper CCM/RPM structure around what you already do, three things happen:
1. New recurring revenue Instead of one-time dispensing margins, you add a monthly clinical revenue stream tied to patient complexity and ongoing support. With even a modest panel of enrolled patients across one or two prescribers, CCM/RPM can grow into six-figure annual revenue for a pharmacy–provider partnership.
2. Stronger patient loyalty The more you are involved in managing chronic conditions, the harder it is for patients to leave. Regular check-ins, help with devices, and proactive outreach keep your pharmacy top of mind and deepen trust.
3. Better outcomes and fewer headaches
CCM and RPM are designed to:
Improve adherence
Catch problems earlier
Reduce avoidable hospitalizations
Smooth out refill patterns and workload over the month
That means healthier patients and a more predictable operation for you.
Signs Your Pharmacy Is Leaving CCM/RPM Money On the Table
You are probably leaving significant value on the table if:
Your team spends hours each week on the phone with the same high-risk patients
You frequently help patients interpret blood pressure, weight, or glucose readings
You are doing med sync and post-discharge work without any added revenue
You know your patients better than anyone else, but that knowledge is not tied to a formal program
If this sounds familiar, you are a prime candidate for a pharmacy-led CCM/RPM model.
How CCM RPM Help Works With Pharmacies
Designing and launching CCM/RPM can feel overwhelming if you try to figure it out alone. That is where we come in.
CCM RPM Help partners with pharmacies to:
Assess your current clinical work We look at what you are already doing today and identify where CCM/RPM can plug in without disrupting your core dispensing operations.
Design a compliant partnership model with prescribers We help you structure win-win relationships with physicians, including workflows, responsibilities, and a framework for shared revenue.
Select and implement the right technology We guide you through choosing CCM/RPM software and devices that fit a pharmacy setting and integrate into your current systems and staffing.
Build workflows, scripts, and training for your team Your staff gets clear roles, call flows, and documentation processes so they know exactly what to do from day one.
Launch, refine, and scale Once you are live, we monitor performance, help you optimize patient selection and workflows, and support you as you expand to more providers and locations.
You are already doing the work.
CCM and RPM are simply the bridge that lets you get paid for the clinical care you are providing every single day.
If you want to explore what a pharmacy-driven CCM/RPM model could look like for your store, your patients, and your local providers, CCM RPM Help can walk you through it step by step.
REQUEST A FREE CCM AND RPM SUPPORT GUIDE TODAY