Can Pharmacists Prescribe in Virginia? 2026 Scope of Practice Guide

Status Check: Virginia is a Yellow State. Current Authority Level: Statewide Protocol

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

The laws in Virginia have changed 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 Virginia.

At-A-Glance: What Can You Prescribe?

Clinical Service	Authority Status	Protocol / Requirement	Billing Code
Hormonal Contraception	✅ YES	US MEC Assessment	CPT 99202
Prenatal Vitamins	✅ YES	Statewide Protocol	Product Only
Flu/Strep	❌ NO (Test Only)	No Treatment Authority	CPT 87880
Paxlovid (COVID-19)	✅ YES	Federal Authority	CPT 99212
Opioid Antagonist	✅ YES	Statewide Protocol	Product Only

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1. Hormonal Contraception Authority

The Law: Virginia Statewide Protocol

In Virginia, pharmacists can furnish hormonal contraception using the US MEC (Medical Eligibility Criteria) Assessment. This includes oral contraceptives, patches, and vaginal rings.

The Protocol: To legally prescribe, you must:

1. Complete the US MEC Assessment for each patient.
2. Screen for contraindications per CDC guidelines.
3. Document the patient encounter and assessment.

⚠️ Key Point: Virginia's protocol uses the CDC's US MEC criteria, which is the gold standard for contraceptive eligibility assessment.

Revenue Potential:

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

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2. Prenatal Vitamins

The Law: Virginia Statewide Protocol

Virginia pharmacists can furnish prenatal vitamins under the statewide protocol, supporting maternal health access.

Requirements:

• Follow the statewide protocol for prenatal vitamin dispensing.
• No additional assessment required beyond standard counseling.

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3. Test & Treat (Flu / Strep)

The Status: Testing Only - No Treatment Authority

In Virginia, pharmacists can perform CLIA-waived testing for flu and strep, but cannot treat. Positive test results must be referred to a prescriber.

What This Means:

• You can bill for the testing service (CPT 87880).
• Treatment requires a physician prescription or referral.

Rx Agent Tip: Consider partnering with telehealth providers to offer seamless test-and-refer services to your patients.

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4. How to Bill for Services in Virginia

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

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

• Portal Link: Virginia Medicaid Provider Enrollment

Commercial Payers: Most commercial plans in Virginia do not yet fully recognize pharmacists as providers. We recommend billing the patient a cash "Consult Fee" and providing a Superbill using the codes above.

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Compliance Checklist for Virginia

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).
• US MEC Training: Have you completed training on CDC eligibility criteria?
• Liability Insurance: Does your policy cover "Prescribing" or just "Dispensing"?
• CLIA Waiver: Is your pharmacy registered as a laboratory?
• Statewide Protocol: Do you have the current protocol on file?

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Need the Official Protocols?

Stop searching through the Virginia Board of Pharmacy website.

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

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"What is the US MEC assessment for contraception in Virginia?"

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