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Pharmacy Care Program
The table below outlines the cognitive services covered as part of the Dean Health Plan (DHP) Pharmaceutical Care Program.
| Equivalent Cognitive Services Covered Under the DHP Pharmaceutical Care Program | NDC Used to Request Reimbursement |
| Therapeutic Interchange – $12 | 99999-9999-33 |
| Change of Dose – $5 | 99999-9999-34 |
| Formulary Interchange – $4 | 99999-9999-32 |
| Patient Compliance Monitoring – $10 | 99999-9999-35 |
| Change of Dose – $5 | 99999-9999-34 |
| Patient Training on Glucose Monitors – $1/min; max $30 | 99999-9999-36 |
| Patient Training on Asthma Inhaler/Peak Flow Meter – $1/min; max $10 | 99999-9999-37 |
| Patient Training on Blood Pressure Monitors – $1/min; max $15 | 99999-9999-38 |
| Patient Training on Nasal Inhalers – $1/min; max $5 | 99999-9999-39 |
Below you will find information pertaining to qualifying services, how reimbursement requests should be submitted and reimbursement rates. Forms you may use for documenting intervention requests to be reimbursed through the Dean Health Plan Pharmaceutical Care Program are also provided for your convenient reference.
If you have additional questions concerning these changes, please contact Dean Health Plan Customer Service at (608) 828-1301 or toll free at (800) 279-1301.
Pharmacy Care Qualifying Services Information (26k PDF file)
Patient Training Pharmacy Care Form (30k PDF file)
Clinical Services Pharmacy Care Form (29k PDF file)
How to Submit Pharmacy Care Program Claim (24k PDF file)
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