Texas Pharmacy Medical Billing: Set Sight on Your New Adventure

Published by Texas Pharmacy Association


In January legislation became effective that was passed during the 2019 Texas legislative session, which allows pharmacists to be in provider networks and to be reimbursed for services that are within their scope of practice. Where do you begin? Mary will dive into various aspects of medical billing available for pharmacy/pharmacists in Texas. Medical billing takes a firm understanding of what is billable, how it is billable, and who pays for these services. Federally, many of these new billable services are not payable under the Medicare program, therefore payer credentialing will be a vital part of being able to accept payment from other payers. We will discuss all of these areas and get you started in the right direction.

At the completion of this activity, pharmacists and technicians will be able to:
1. Discuss what services are billable.
2. Describe the enrollment process for health plan provider networks and how to begin the payer credentialing process.
3. Explain the billing process and differences between billing a pharmacy claim and a medical claim.
4. Identify steps to get pharmacists paid through medical claims by health plans as healthcare providers.

”ACPEThis lesson is a knowledge-based CE activity and is targeted to pharmacists and technicians. This program has been approved for 1.5 contact hours of continuing education credit (0.15 CEUs).

ACPE 0154-0000-20-009-H04-P
ACPE 0154-0000-20-009-H04-T

Texas Pharmacy Association (154) is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. Credit has been approved with the Accreditation Council for Pharmacy Education for 0.15 CEU credits and 1.5 Contact Hour credits. This credit is valid until 7/23/2023.

Mary Stoner
President/CEO - Electronic Billing Services Incorporated
Mary Stoner is the President/CEO of Electronic Billing Services Inc (EBS). EBS, established in 1994, is a national medical billing and consulting company. EBS provides assistance with enrollment, credentialing, compliance monitoring, billing, reconciliation, denial management, audit submission, and consulting. Mary has been active in the industry since 1988 and is serving as the Past Chair for the DAC D Medicare Advisory Committee where she has been a member since 2001. Mary also serves on...More

Originally Published

July 24, 2020

Program Titles and Supporting Materials

This program contains the following components:

  • Texas Pharmacy Medical Billing: Set Sight on Your New Adventure - Video
  • Texas Pharmacy Medical Billing: Set Sight on Your New Adventure - Paper

How To Attend

Join the self-paced program from your office, home, or hotel room using a computer and high speed internet connection. You may start and stop the program at your convenience, continue where you left off, and review supporting materials as often as you like. Please note: Internet Explorer is no longer a supported browser. We recommend using Google Chrome, Mozilla Firefox or Safari for best results.

Technical Requirements

You may access this course on a computer or mobile device with high speed internet (iPhones require iOS 10 or higher). Recommended browsers are Google Chrome or Mozilla Firefox.


If applicable, you may obtain credit in multiple jurisdictions simultaneously for this program (see pending/approved list below). If electing credit for this program, registrants in jurisdictions not listed below will receive a Certificate of Completion that may or may not meet credit requirements in other jurisdictions. Where applicable, credit will be only awarded to a paid registrant completing all the requirements of the program as determined by the selected accreditation authority.

Click on jurisdiction for specific details

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