Ensuring Community Access to Pharmacist Services Act

Medicare would pay pharmacists directly for COVID, flu, RSV and strep visits — and bar them from billing patients extra.

The details

Medicare Part B would start paying pharmacists directly for a narrow set of visits. Covered services are testing or treatment for COVID-19, influenza, RSV, and strep throat. Testing and treatment tied to a declared public health emergency would also be covered. Where state law requires it, the pharmacist must work under a physician's supervision or in collaboration with one. Medicare would pay 80 percent of the lesser of the actual charge or 85 percent of the physician fee schedule rate. For public health emergency services, the rate rises to the full physician amount. Pharmacists could not bill patients for the difference between their charge and what Medicare allows. The change would apply to services furnished on or after January 1, 2026. For older adults in communities without a nearby doctor's office, it would make a pharmacy counter a billable place to get treated for a common respiratory illness.