Can Pharmacists Prescribe in Washington? 2026 Scope of Practice Guide

Status Check: Washington is a Green State. Current Authority Level: Standard of Care Model (CPA)

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

The laws in Washington 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 Washington.

At-A-Glance: What Can You Prescribe?

Clinical Service	Authority Status	Protocol / Requirement	Billing Code
Any Legend Drug	✅ YES (via CPA)	Collaborative Agreement	CPT 99213
Hormonal Contraception	✅ YES	Direct Pharmacy Access	CPT 99202
Paxlovid (COVID-19)	✅ YES	Standard of Care	CPT 99212
HIV PrEP/PEP	✅ YES	CPA or Protocol	CPT 99213
Opioid Antagonist	✅ YES	Statewide Protocol	Product Only

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1. Collaborative Practice Authority

The Law: Washington Standard of Care Model

Washington State has one of the most expansive pharmacist prescribing models in the nation. Under a Collaborative Practice Agreement (CPA), pharmacists can prescribe any legend drug within the scope of the agreement.

The Protocol: To leverage this authority:

1. Establish a Collaborative Practice Agreement with a physician or healthcare system.
2. Define the scope of prescribing authority within the CPA.
3. Follow standard of care protocols for each therapeutic area.

⚠️ Key Point: Washington's CPA model allows pharmacists to practice at the top of their license. This is gold-standard authority.

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2. Hormonal Contraception Authority

The Law: Direct Pharmacy Access

In Washington, pharmacists can furnish hormonal contraception directly to patients without a collaborative practice agreement. This is one of the most accessible models in the country.

The Protocol: To legally prescribe, you must:

1. Use a standardized screening questionnaire.
2. Assess contraindications per clinical guidelines.
3. Document the patient encounter.

Revenue Potential:

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

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3. Paxlovid (COVID-19 Treatment)

The Law: Standard of Care Authority

Washington pharmacists can prescribe Paxlovid under standard of care provisions, making COVID-19 treatment highly accessible.

Requirements:

1. Perform renal function assessment.
2. Screen for drug-drug interactions.
3. Document clinical decision-making.

Rx Agent Tip: Washington's progressive approach means less red tape—focus on patient care, not paperwork.

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4. How to Bill for Services in Washington

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

Medicaid Enrollment: To bill Washington Apple Health (Medicaid) for CPT codes (like 99202, 99212, 99213), you must enroll as an Ordering/Referring Provider.

• Portal Link: Washington Apple Health Provider Enrollment

Commercial Payers: Washington has strong payer recognition of pharmacists as clinical providers. Many commercial plans will reimburse for pharmacist services directly.

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Compliance Checklist for Washington

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).
• CPA (if applicable): Is your Collaborative Practice Agreement current and on file?
• Liability Insurance: Does your policy cover "Prescribing" or just "Dispensing"?
• CLIA Waiver: Is your pharmacy registered as a laboratory?
• Protocols: Do you have treatment protocols for your scope of services?

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Need the Official Protocols?

Stop searching through the Washington State Pharmacy Quality Assurance Commission website.

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

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