Buy-and-Bill Model May Improve Access and Practice Control in Dermatology

The buy-and-bill reimbursement model may provide dermatology practices with greater control over treatment delivery, faster patient access to therapy, and potential operational advantages, according to Mark D. Kaufmann, MD, during his session, “The Smart Way to Treat: ​Buy-and-Bill for Dermatology,” presented during Music City SCALE 2026.

The session reviewed the mechanics and practical implications of buy-and-bill, a system in which practices purchase medications directly, administer them in-office, and bill insurers for both the medication and administration services. Unlike specialty pharmacy distribution, the model allows practices to manage the “drug lifecycle from acquisition to treatment.”

Dr Kaufmann emphasized that buy-and-bill is considered a “medical service, not pharmaceutical,” typically billed under Medicare Part B rather than Part D. Reimbursement often follows the ASP+6% framework and includes associated CPT billing for administration.

One major advantage discussed was improved treatment access. Because medications are stored and administered directly in the clinic, patients may avoid delays commonly associated with specialty pharmacy coordination and shipment. The presentation noted that buy-and-bill “reduces delays compared to specialty pharmacy dispensing,” which may improve continuity of care and treatment adherence.

The model is increasingly relevant in dermatology as more injectable and office-administered therapies enter clinical practice. Examples highlighted included biologic therapies, such as tildrakizumab, certolizumab pegol, and omalizumab, as well as photodynamic therapy agents like aminolevulinic acid and procedural agents, including cantharidin and wound-healing grafts.

However, Dr Kaufmann also emphasized operational and financial complexity. Practices assume upfront purchasing costs and inventory responsibilities, creating financial exposure if claims are denied or products are wasted. Inventory tracking, insurance verification, and reimbursement management are critical components of implementation.

Dr Kaufmann recommended a phased approach for practices considering adoption. “Start small with 1 or 2 medications,” he advised, while building infrastructure, including coordinators and billing personnel. Staff education and workflow optimization were also identified as essential for long-term success.

Although reimbursement timelines may extend to several weeks, the model may still offer advantages by allowing practices to retain greater oversight of treatment scheduling and administration.

Dr Kaufmann concluded that buy-and-bill can “enhance access, treatment efficacy, and practice efficiency,” but requires “proper systems, staff, and oversight for success.”

For more meeting coverage, visit the Music City SCALE newsroom.

Reference
Kaufmann M. The smart way to treat: buy-and-bill for dermatology. Presented at: Music City SCALE Symposium; May 13–17, 2026; Nashville, TN.