“A bill to amend title XVIII of the Social Security Act to provide pharmacy payment of certain services.”
No CRS summary available for this bill.
This section establishes coverage under Medicare Part B for pharmacist services (as defined in new subsection 1861(nnn)), effective for services furnished on or after January 1, 2026. Pharmacist services are those furnished by a pharmacist legally authorized under state law (meeting applicable supervision or collaboration requirements with a physician or practitioner) that would otherwise be covered if furnished by a physician, limited to (1) evaluation and management visits for COVID-19, influenza, respiratory syncytial virus, or streptococcal pharyngitis; or (2) testing or treatment addressing a public health need during a public health emergency declared under section 319 of the Public Health Service Act. It provides payment equal to 80 percent of the lesser of the actual charge or 85 percent of the physician fee schedule amount under section 1848 (or 100 percent of such fee schedule amount for services in category (2)). It also extends physicians' assignment requirements and balance billing prohibitions to pharmacists.