Medication Reconciliation Post-Discharge (MRP): Billing Codes for Reimbursement
Defines Anthem's billing codes, documentation, eligibility, and reimbursement stance for Medication Reconciliation conducted within 30 days of inpatient discharge for Medicare Advantage members and related measurement criteria.
Anthem is preparing to reimburse providers who conduct medication reconciliation within 30 days of an inpatient hospital discharge for Medicare Advantage members using CPT Category II code 1111F.
Medication Reconciliation Post-Discharge — Coverage & Documentation
MRP coverage and documentation criteria
Covered when ALL of the following measurement, documentation, performer, and billing conditions are met:
ALL of the following
Eligibility
- Member age is 18 years or older (measure applies to members >= 18).
Denominator is based on discharges; multiple discharges for the same member are each counted.
- Discharge from an acute or non-acute inpatient facility.
- Medication reconciliation completed within 30 days of the date of discharge (measurement counts date of discharge through 30 days after discharge).
Documentation
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.