Can Pharmacists Prescribe in Michigan? 2026 Scope of Practice Guide

Status Check: Michigan is a Green State. Current Authority Level: Independent Prescribing (Delegated)

If you are a pharmacist in Michigan, you are likely leaving revenue on the table—or practicing efficiently but dangerously.

The laws in Michigan have changed significantly in recent years. Whether you are looking to launch a "Test and Treat" clinic or just want to legally dispense Paxlovid, you need to know exactly which protocol protects your license.

Here is the Breakdown of Pharmacist Prescribing Authority for Michigan.

At-A-Glance: What Can You Prescribe?

Clinical Service	Authority Status	Protocol / Requirement	Billing Code
Hormonal Contraception	✅ YES	Standing Order + BP Check	CPT 99202
Flu/Strep Testing	✅ YES	CDTM / Protocol	CPT 87880 + 99211
Paxlovid (COVID-19)	✅ YES	Renal Assessment	CPT 99202
HIV PrEP/PEP	⚠️ Limited	Collaborative Practice	N/A
Opioid Antagonist	✅ YES	Statewide Protocol	Product Only

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1. Hormonal Contraception Authority

The Law: Michigan Statewide Standing Order

In Michigan, pharmacists can furnish hormonal contraception under a statewide standing order. This includes oral contraceptives, patches, and vaginal rings.

The Protocol: To legally prescribe, you must:

1. Follow the Michigan Statewide Standing Order for hormonal contraception.
2. Perform a Blood Pressure Check and document results.
3. Use the standard screening questionnaire to assess contraindications.

⚠️ Audit Trap: Blood pressure documentation is mandatory. Missing BP readings are the most common compliance failure in Michigan.

Revenue Potential:

• Consult Fee: $35-50 (Cash) or CPT 99202 (Medicaid).
• Product: Standard dispensing margin.

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2. Test & Treat (Flu / Strep)

The Law: Collaborative Drug Therapy Management (CDTM)

Michigan allows pharmacists to test and treat influenza and streptococcal infections under CDTM protocols or collaborative practice agreements.

The Workflow:

1. Test: Perform a CLIA-waived rapid test.
2. Evaluate: Assess for high-risk criteria and symptoms.
3. Treat: If positive, prescribe appropriate therapy per protocol.

Rx Agent Tip: Ensure your CDTM agreement is current and filed with the Board before offering these services.

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3. Paxlovid (COVID-19 Treatment)

The Law: Federal and State Authority

Michigan pharmacists can prescribe Paxlovid with appropriate renal assessment and drug interaction screening.

Requirements:

1. Obtain or calculate renal function (eGFR/CrCl).
2. Review current medications for interactions.
3. Document the clinical decision-making process.

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4. How to Bill for Services in Michigan

It is not enough to do the work; you must get paid.

Medicaid Enrollment: To bill Michigan Medicaid for CPT codes (like 99202, 87880, 99211), you must enroll as an Ordering/Referring Provider.

• Portal Link: Michigan Medicaid Provider Enrollment

Commercial Payers: Most commercial plans in Michigan are beginning to recognize pharmacists as providers for clinical services. We recommend billing the patient a cash "Consult Fee" and providing a Superbill using the codes above.

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Compliance Checklist for Michigan

Before you write your first prescription, ensure you have these documents on file:

• NPI Type 1: Do you have an individual NPI? (Type 2 is for the pharmacy).
• CDTM Agreement: Is your Collaborative Drug Therapy Management agreement current?
• Liability Insurance: Does your policy cover "Prescribing" or just "Dispensing"?
• CLIA Waiver: Is your pharmacy registered as a laboratory?
• Standing Order: Do you have the statewide standing order on file?

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Need the Official Protocols?

Stop searching through the Michigan Board of Pharmacy website.

Rx Agent has the official, up-to-date Protocols and Standing Orders for Michigan built right into the chat.

Ask Rx Agent:

"Show me the standing order requirements for birth control in Michigan."

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