Minnesota pharmacists can independently prescribe self-administered hormonal contraceptives under state-mandated protocols.
Standing Order
Not applicable; pharmacists operate under state-mandated protocols.
Collaborative Practice Agreements (CPA)
While independent prescribing is permitted, pharmacists may also prescribe under CPAs with supervising healthcare providers as outlined in Minn. Stat. §151.01, Subd. 27(6) and §151.37, Subd. 2.
Eligible Medications: Contraceptive pills, patches, and vaginal rings.
Prescription Limitations:
Up to 12 months’ supply (refills) of contraceptives.
Patients must complete a NEW Patient Intake Form every 12 months before receiving a pharmacist-prescribed contraceptive.
Follow-up required after three years of the patient's last clinical visit.
Age Restrictions:
Patients must be 18 years or older.
Patients under 18 require documentation of a prior prescription from a licensed healthcare provider.
Documentation Requirements:
The completed questionnaire should be kept on file for a minimum of two years.
If the patient does not complete the questionnaire, a prescription cannot be issued.
The patient must fill out the questionnaire at least once every 12 months.
Training Requirements: Pharmacists must complete a Board-approved contraceptive prescribing training program before providing services.
Reimbursement Details
Eligibility
Pharmacists must be enrolled as Medicaid providers to render and bill for covered contraceptive services.
Covered under both Minnesota Medicaid (Medical Assistance) and the Minnesota Family Planning Program (MFPP) for eligible recipients. Verify recipient eligibility for MFPP via the MN–ITS system prior to rendering services.
Billing Codes
Pharmacists must use appropriate CPT/HCPCS codes for evaluation, counseling, and prescribing services:
Contraceptive management visits: CPT 99201–99215 depending on time and complexity.
Counseling-only visits may require modifier usage (see “Submission Process”).
Submission Process
Claims must be submitted through MN–ITS, Minnesota’s Medicaid billing system.
Submit claims using the 837P format (electronic) or CMS-1500 (paper), as applicable.
Reference the Physician and Professional Services Manual and the Pharmacy Services Manual for service-specific billing instructions. Must also include appropriate NDC codes for dispensed contraceptives.
Pharmacists must follow state-specific billing guidance provided by the Department of Human Services (DHS), including the use of Minnesota-defined U Modifiers:
U1 – Service provided at a Title X clinic, U2 – Client declines family planning services, U3– MFPP visit only, U4 – Family planning-related service.
