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Enables independent prescribing of contraceptives by pharmacists under state guidelines.
Helpful Links: Utah Code § 58-17b-803 & Administrative Rule R156-17b.
Pro's: Easiest to implement, no state forms required, simply follow standard of practice for prescribing.
Con's: regulations are weak
Allows pharmacists to prescribe contraceptives following patient assessment protocols.
Helpful Codes: Utah Code § 26B-4-505 & R433-200.
Allows prescribing under agreements with supervising healthcare providers.
Helpful Links: (CPA), Utah Code § 58-17b-102 & R156-17b-614.
Eligible Medications: Contraceptive pills, patches, and vaginal rings.
Prescription Limitations: Up to 12 months of refills. Follow-up required after two years.
Age Restrictions: Patients must be 18 years or older.
Documentation Requirements: Maintain patient records for 7 years; comply with HIPAA regulations.
Training Requirements: Completion of state-mandated courses for prescribing and patient counseling.
Eligibility:
Billing Codes:
Use CPT Code 99401 (preventive counseling) with FP Modifier for family planning services. Pharmacy claims for self-administered hormonal
contraceptives must include one of the following diagnosis codes:
Dispensing Fee:
Pharmacists can receive a dispensing fee for prescriptions billed under Medicaid when using their Medicaid-registered individual NPI.
Submission Process:
Submit claims via Utah Medicaid PRISM system.

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