Advancing The Profession of Pharmacy

[February 2019] Pharmapreneur Community Newsletter

by | Feb 28, 2019 | Consulting Pharmacist Education


Having a good handle on your personal finances is the best head start you can give yourself in business.

Do you have a good understanding of personal expenses (whether you use the “b” word or not … budget)?

If so, it will be easier to calculate how much money you actually need to walk away from a job.

Pharmacists often ask me:
How long will it take to replace my pharmacist salary so I can leave my job?


But I think that’s the wrong question.

You should first ask yourself:

What are  my base fixed expenses that I must pay each month?

When I put my pen to paper and really looked at my budget, I realized how little I actually needed to cover the basics!

I had no idea how much less I could live off of until I wrote it down.

That knowledge made my transition to entrepreneurship much less scary.

The first year, after I lost my job, I took a $40,000 pay cut! But working for myself set me free.

I also made every mistake there is to make on my road to entrepreneurship.

That is why I invited Your Financial Pharmacist founder and author of The Seven Figure Pharmacist, Tim Ulbrich, to our February Member Call to talk about “How to Become a Seven Figure Pharmapreneur.”

I want Pharmapreneur Academy members to avoid the same missteps I made on my journey.


Tim will teach us calculations and exercises to help us put our personal finances in order and build our businesses on a healthy financial foundation.

I will also SHARE my own experiences with personal finance and how it’s changed my life.

My kids are still a bit young to understand money but when we begin talking about it my first lesson to them will be:

“You can afford ANYTHING you want, but can’t afford EVERYTHING.” – Paula Pant

I think that applies to business, too.

You can afford to build the business of your dreams.  As soon as you are willing to sit down and look at what you’re no longer willing to waste money, time, and energy on.

Once you focus, you can redirect those resources into your business.



Do you remember the “regular” CCM code 99490?

It codes for about 20 minutes of a non-provider clinical staff member visit with a patient enrolled in a chronic care management (aka CCM) program.

Code 99490 is for a once monthly non face to face visit with a patient that generally reimburses for about $42.

As of January 2019 the Centers for Medicare and Medicaid introduced a new code for CCM: 99491.

The “little sister code,” 99490, is for 20 minutes of non provider contact with a patient. The new code 99491 is for 30 minutes of “directly involved provider care.” That means it needs to be provided by a qualified healthcare professional instead of clinical staff member.

At this point I would not recommend that pharmacists attempt to bill for code 99491  since in most states we do not have qualified health care provider status.

The difference in reimbursement, however is quite generous.

If you are practicing with a provider who spends a little bit of extra time with the patient in a given month the provider is able to bill for their time using the new higher reimbursing code.

Whereas the 99490 code reimburses for about $42 dollars the new one reimburses for between $74 and $84 dollars

At 30 minutes versus 20 minutes, code 99491 pays almost double what you would be paid for the 20 minute 99490 visit, thus reflecting the provider’s direct involvement.

We expect to see code 99491 being used in place of with 99490 when on a certain month the provider must be more involved.

However the 99490 and 99491 codes cannot be used together in the same calendar month.

Additionally if you’ll refer back to our complex and chronic care management code video you’ll see there’s also a “complex code 99487” that codes at an even higher rate for a more complicated patient visit.

Code 99487 cannot be used at the same time as a 99491 visit either.  CMS wanted to give providers who are more involved in the patient’s care a chance at the higher reimbursement.

If, for example, the next month it can return to clinical staff member (or pharmacist) they can return to using the 99490 code.
Just remember, right now, only ONE of the codes, 99490, 99491 or 99487 may be used per month based on the level of care provided.


If you’re interested in learning more about chronic care management, get more information and videos like this one delivered straight to your inbox by registering at

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Exciting news Pharmapreneurs!

Our new podcast featuring interviews from the very first Elevate Pharmacy Virtual Summit has now launched.

Not familiar with the Summit?

The Summit is a way for pharmacy professionals to earn continuing education hours by listening to or watching interviews with industry experts.  You can listen anywhere, like, the comfort of your own home.

“We love the virtual summit because it allows all members of our pharmacy team to watch the interviews and get excited about the content.”

It can be tough for one person to come back from a conference and relay the excitement and information to others

We know that not everyone can travel. But now there is a way to share in the experience while learning everything that’s usually only available to conference attendees.

The Elevate Pharmacy Summit Podcast Season 1

Interviews about consulting in ambulatory care settings from:

⇢ Amina Abubakar
⇢ Joshua Akers, PharmD, BCACP
⇢ Nicholas Dorich
⇢ Mary Ann Kliethermes
⇢ Sandra Leal
⇢ Ashley Lorenzen PharmD BCPS
⇢ Kate Morton
⇢ Sue Paul
⇢ Michelle Thomas
⇢ DeArcy Vaughan, PharmD, MBA, BCACP, CDE, CTTS

Listen to these interviews and get excited for this year’s Elevate Pharmacy Virtual Summit, May 8-12, 2019!

You can get your free ticket at ElevatePharmacySummit.comNot a podcast junkie (yet)?  Here’s how to get on-board:

  1. On  your phone, look for the podcast app (on iPhone its purple like the one above)
  2. Search for “Elevate Pharmacy Summit” and you should see the picture below
  3. Click on the picture and then click “Subscribe”
  4. The episodes will begin downloading and you’re free to listen in your car, in the gym or wherever you want!
  5. For those who would prefer to listen on a desktop, you can do so by going to the podcast player on our website at
  6. And if you want to help other pharmacists find our show, leave us a rating and review by clicking here!

Keep an eye out for Season 2 to drop around the middle of March.

GxRPh: The Academy’s Latest Training Course!

“Blair, good news. I set up a meeting with my local clinic’s quality director and providers. I can’t believe this is happening.I’ve always wondered how I could get involved with a clinic but because of the Pharmapreneur Academy I’ve actually started taking steps towards this goal. Thank you for all your help.”

This is a message I received from one of my Pharmapreneur Academy members. I love getting these messages because it reminds me of the rush that comes with new opportunities.

As a pharmacist, you may think you’re “stuck” in a certain type of job, but you’re not. I found MTM consulting and it changed my life. Now I’d like to help change yours.

If you are interested in learning more about Pharmapreneur Academy, sign up for this Sunday’s LIVE webinar!

The free, Live training is March 3rd at 4pm CST


“It was a great small group experience that helped me see people in all walks of life trying to achieve a dream. Totally different than what I expected because it wasn’t a group of just independent pharmacy owners trying to make ends meet. I did love that it was all women as most groups are mixed. I would love to do this again!”
​-2018 Retreat Attendee

What is a MASTERMIND group?

A mastermind group offers a combination of brainstorming, education, peer accountability and support in a group setting to sharpen your business and personal skills.

I joined my first mastermind in 2016 with a group of women that saw eye-to-eye. I didn’t come from a family of entrepreneurs, so having other business owners to talk to was a huge benefit.

It’s because of that experience that I am hosting my second mastermind retreat for female pharmacists!

We will meet in Las Vegas for two days (Sept. 13 & 14, 2019) to help you plan and develop new projects for the year and discuss opportunities for growing your business.

If you are interested, read more in the blog post and email me directly to see if you’d be a good fit!


Personal development is SO important for the business owner and the business.


The Pharmapreneur Academy has some specific recommendations for services to offer. However much of it is business related advice (not clinical) and can translate to many different business models in pharmacy.

Most of our members are either implementing consulting services in the community pharmacy setting (health coaching, weight management, genetic testing, etc) or in an ambulatory care setting under a collaborative physician.

We now have over 160 members in the Pharmapreneur Academy and many of them started with some of the same questions you probably have right now.

We’ve got members ranging from the brand-new entrepreneur to more advanced business owners who already have a consulting arrangement, but need help refining their model.

There are 3 essential “legs” of the Pharmapreneur Academy: the e-Course, the Forums and the Monthly Member Calls.

  1. The e-Course – a step-by-step program that will help you build, grow and implement your consulting services.
  2. The Forums – give you a place to ask questions, seek support and share ideas with the other members.
  3. The Member Calls – once monthly video conference calls where we’ll either do a Live Masterclass training or have a Q&A session.

The February member call is a training with Tim Ulbrich   an expert on pharmacist personal finance and author of The Seven Figure Pharmacist “.

It can be attended live or accessed via replay in the Academy Forums.

The Pharmapreneur Academy is a good fit for pharmacists who are thinking about offering innovative services, but aren’t sure exactly where to start.

The e-course at the Academy is a comprehensive business coaching program for pharmacists wishing to start offering advanced consulting services.

Thanks so much for reading and I’ll see you right here again next Month!

About the Author

Blair Thielemier, PharmD, is a business development consultant specializing in pharmacist-led billing models. She has set the industry standard for virtual pharmacy conferences with the Elevate Pharmacy Virtual Summit in 2017. She has consulted with national pharmacy organizations, drug wholesalers, point of sale companies, and Fortune 5 health insurers. She has books and online courses available for individuals looking to leverage their pharmacy knowledge into monetized clinical programs at She speaks internationally about trends in leveraging pharmacists to improve value-based care.


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