Can pharmacists in Ohio prescribe hormonal contraception?

**Conditional.** Hormonal contraception requires a Consult Agreement with a physician. Independent authority is not available.

What CPT codes can pharmacists bill in Ohio?

In Ohio, pharmacists can typically bill **CPT 99213, 87804** for assessment and evaluation, provided they are enrolled as a provider with Ohio Medicaid.

Can Pharmacists Prescribe in Ohio? 2026 Scope of Practice Guide

Status Check: Ohio is a Green State. Current Authority Level: Provider Status (Consult Agreements)

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

The laws in Ohio 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 Ohio.

At-A-Glance: What Can You Prescribe?

Clinical Service	Authority Status	Protocol / Requirement	Billing Code
Chronic Care (DM/HTN)	✅ YES	Consult Agreement	CPT 99213
Flu/Strep	✅ YES	Board Rule 4729	CPT 87804
Hormonal Contraception	⚠️ Conditional	Consult Agreement Req	N/A
Paxlovid (COVID-19)	✅ YES	Federal Authority	CPT 99212
Opioid Antagonist	✅ YES	Statewide Protocol	Product Only

1. Chronic Care Management Authority

The Law: Ohio Consult Agreement Model

Ohio recognizes pharmacists as providers for chronic disease management under Consult Agreements. This includes diabetes and hypertension management.

The Protocol: To leverage this authority:

Establish a Consult Agreement with a physician or healthcare system.
Define scope of care including medication adjustments.
Document all patient encounters and clinical decisions.

⚠️ Key Point: Ohio's provider status opens doors for MTM billing and chronic care revenue.

2. Test & Treat (Flu / Strep)

The Law: Board Rule 4729

Ohio allows pharmacists to test and treat influenza and streptococcal infections under Board Rule 4729.

The Workflow:

Test: Perform a CLIA-waived rapid test.
Evaluate: Assess symptoms and patient history per protocol.
Treat: If positive, prescribe appropriate therapy.

Revenue Potential:

Testing Fee: Bill CPT 87804 for rapid strep test.
Evaluation: Add evaluation code for comprehensive service.

3. Hormonal Contraception Authority

The Status: Conditional

In Ohio, pharmacists cannot independently furnish hormonal contraception. This service requires a Consult Agreement with a supervising physician.

What This Means:

Partner with a local physician to establish a Consult Agreement.
Include hormonal contraception in your scope of services.
Follow all documentation and patient assessment requirements.

Rx Agent Tip: While not independent authority, Consult Agreements can still enable you to provide this service to patients who need it.

4. How to Bill for Services in Ohio

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

Medicaid Enrollment: To bill Ohio Medicaid for CPT codes (like 99213, 87804), you must enroll as an Ordering/Referring Provider.

Portal Link: Ohio Medicaid Provider Enrollment

Commercial Payers: Ohio has strong support for pharmacist provider status. Many commercial plans recognize pharmacists for chronic care services.

Compliance Checklist for Ohio

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).
Consult Agreement: Is your agreement current and properly executed?
Liability Insurance: Does your policy cover "Prescribing" or just "Dispensing"?
CLIA Waiver: Is your pharmacy registered as a laboratory?
Board Rule 4729 Compliance: Are you following all Board requirements?

Need the Official Protocols?

Stop searching through the Ohio Board of Pharmacy website.

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

Ask Rx Agent:

"How do I set up a Consult Agreement in Ohio?"

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