Scope of Practice and Compensation for Services
Scope of Practice and Compensation for Services
Community pharmacists are the most accessible health care providers in the country. Expanding pharmacists' scope of practice allows patients to receive timely care for common conditions, preventive services, chronic disease management, and medication-related needs without unnecessary delays. NCPA works with state pharmacy associations and policymakers to remove barriers that prevent pharmacists from practicing to the full extent of their education and training while ensuring patients receive safe, high-quality care.
State Best Practice Language
States have taken a variety of approaches to modernizing pharmacy practice laws. The examples below highlight best-practice statutory language that supports pharmacist autonomy, patient access to care, and sustainable payment for pharmacist-provided services.
Standard of care:
- Idaho:
- Idaho Code § 54-1705 (Practice of Pharmacy — General Approach)
- Idaho Code § 54-1726 (Grounds for Discipline)
- Iowa:
- Iowa Code § 155A.2B (Practice of Pharmacy — General Principles)
- Iowa Code § 155A.12 (Pharmacist License — Grounds for Discipline)
Broad independent prescribing authority:
- Montana: 37-7-106, MCA
- Idaho: Idaho Code § 54-1734
Test and treat:
- Montana: 37-7-106, MCA
- Colorado: C.R.S. 12-280-103 (39)
Medication administration:
- Colorado: C.R.S. 12-280-103 (39)
Collaborative practice:
- Washington: WAC 246-945-350
Delegation:
- Idaho: Idaho Code § 54-1705 (Standard of Care)
Payment for services:
- Washington: Rev. Code Wash. (ARCW) § 48.43.094
- Maryland: Md. Insurance Code § 15–716
Additional resources:
- APhA: Pharmacists' Patient Care State Fact Sheets
- Cicero Institute: Unlocking Pharmacist Innovation: 2025 Policy Strategies for Full Practice Authority
- JAPhA: How to implement a "standard of care" regulatory model for pharmacists
- NCSL: Scope of Practice Policy | Pharmacists
- NABP: Model Pharmacy Act/Rules
Rural Health Transformation Program
The Rural Health Transformation Program supports state-led efforts to strengthen access to health care in rural communities through innovative care delivery and payment models. NCPA works with state pharmacy associations and other stakeholders to ensure community pharmacies are recognized as essential health care providers within these initiatives, creating opportunities to expand pharmacists' roles, improve patient access to care, and advance sustainable reimbursement models that support the long-term viability of independent pharmacies.
To support these efforts, NCPA has developed the Community Pharmacy Research Library , a collection of research, reports, and other resources that demonstrate the value of community pharmacy and can help stakeholders make the case for pharmacist integration into rural health transformation initiatives.
Federal Advocacy
PREP Act amendments for pharmacists' vaccine and testing authority
Since 2020, licensed pharmacists in all 50 states have been able to use this federal authority to expand vaccination and testing services to more patients where it hadn't previously been permitted within the state's pharmacy scope of practice. The U.S. Department of Health and Human Services (HHS) extended the PREP Act protections for pharmacists' vaccine and testing authority through Dec. 31, 2029. The decision allows pharmacists, pharmacy interns, and pharmacy technicians to continue independently administering vaccines and test-to-treat services for COVID-19. The authority was set to expire at the end of 2024. NCPA was instrumental in advocating this change with HHS. Details on the extension are available in the Federal Register .
Main Street Pharmacy Access Act
H.R. 3164 ensures Medicare beneficiaries can easily access health care services by authorizing pharmacists to test and treat COVID-19, flu, respiratory syncytial virus (RSV), and strep throat. These policies recognize pharmacists and the role they play in improving health care access by establishing direct reimbursement through Medicare Part B for these pharmacist services. Independent pharmacies have played a significant role at both the federal and state levels in testing for COVID-19 and administering COVID-19 vaccines to their communities and long-term care facilities, and this legislation would ensure continued patient access to these services at their local pharmacy.