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Perform an MTM Intervention
  1. Complete a Comprehensive Medication History (CMH) Interview Form - Click HERE

    • Pharmacist Documentation
      • Listen to the patient interview.
      • Fill out the CMH interview form while listening to the interview.

  2. Complete a Comprehensive Medication Review (CMR) Worksheet - CLICK HERE

    • Pharmacist Documentation
      • Complete ALL sections of this worksheet.
      • It is intended to help guide the pharmacist in analyzing patient data gathered during the CMH interview.

  3. Complete all three Patient Documentation Forms and submit electronic CMR documentation - CLICK HERE

    • Patient Documentation
      • Reimbursement for pharmacist services requires the patient be given:
        1. Cover Letter (CL)
        2. Medication Action Plan (MAP)
        3. Personal Medication List (PML).
    • Complete the electronic CMR documentation and print a hard copy.

Pharmacy Computer System - MTM Services Software