Jennifer Pruskowski, PharmD, PhD, BCPS, BCGP and Sean M. Jeffery, PharmD, BCGP, FASCP, AGSF
For years, clinicians have known that deprescribing is clinically important. Every day, health care professionals identify unnecessary medications, reduce adverse drug events, prevent falls, minimize drug interactions, and help patients navigate medication burden.
The challenge was never whether deprescribing mattered.
The challenge was that the health care system often treated deprescribing as invisible work.
That is beginning to change.
In 2026, CMS released new guidance outlining how supervised medication deprescribing services may be billed under the Medicare Physician Fee Schedule. The guidance recognizes deprescribing as a longitudinal, team-based clinical activity requiring ongoing assessment, care coordination, and medication management expertise. Importantly, the framework also highlights opportunities for pharmacists and other clinicians to contribute meaningfully within interdisciplinary care models. (cms.gov)
This is a significant shift.
Historically, deprescribing activities were often embedded within broader evaluation and management services, making the work difficult to operationalize, scale, or sustain financially. The new CMS guidance acknowledges something front-line clinicians have understood for years: safe medication reduction requires time, communication, follow up, and clinical judgment.
That recognition comes at a critical time.
Health care systems are increasingly focused on reducing medication-related harm, preventable hospitalizations, falls, cognitive impairment, and inappropriate polypharmacy—particularly among older adults with multiple chronic conditions. Deprescribing directly supports value-based care initiatives, quality metrics, and patient-centered outcomes.
But deprescribing is not simply “stopping medications.”
It requires clinicians to evaluate evolving evidence, weigh risks and benefits, align care with patient goals, communicate effectively with patients and caregivers, and coordinate across disciplines. These are learned skills that require training, structure, and implementation support.
That gap is what inspired the development of the American Pharmacists Association’s Patient-Centered Deprescribing in Older Adults Certificate Training Program.
The curriculum was intentionally designed as an interprofessional, patient-centered program that prepares clinicians to operationalize deprescribing in real-world practice. Through case-based learning and implementation-focused modules, participants learn practical strategies for medication assessment, communication, workflow integration, and sustainment of deprescribing services across health care settings.
At the same time, the program recognizes the unique role pharmacists play within the deprescribing process.
Pharmacists are often the clinicians most comprehensively trained in medication management and are uniquely positioned to identify potentially inappropriate medications, assess cumulative medication burden, support monitoring plans, and collaborate with prescribers and care teams. As health care increasingly shifts toward team-based and value-driven care models, pharmacists are well-positioned to help lead deprescribing initiatives across ambulatory care, geriatrics, primary care, long-term care, and population health settings.
The curriculum also intentionally incorporates operational topics that are becoming increasingly relevant in modern health care, including implementation science, informatics tools, AI, communication frameworks, and business planning for deprescribing services.
Because the future of deprescribing is no longer theoretical.
CMS has signaled that deprescribing is valuable clinical work deserving recognition within the health care payment system. Clinicians who develop expertise in deprescribing will be increasingly important to improving medication safety, advancing quality initiatives, and delivering patient-centered care.
Jennifer Pruskowski, PharmD, PhD, BCPS, BCGP, assistant professor and director of geriatric pharmacy research and education, University of Pittsburgh School of Medicine
Sean M. Jeffery, PharmD, BCGP, FASCP, AGSF, professor of pharmacy practice and director of pharmacy, Department of Pharmacy Practice and Integrated Care Partners
UConn School of Pharmacy and Hartford HealthCare