This legislation, titled the "Pharmacy and Medically Underserved Areas Enhancement Act," proposes to expand Medicare coverage to include specific pharmacist services. It mandates that Medicare Part B cover services furnished by state-licensed pharmacists, provided these services are within their legal scope of practice and would typically be covered if performed by a physician or as incident to a physician's service. A key provision is that these covered pharmacist services must be delivered in designated health professional shortage areas , medically underserved areas, or for medically underserved populations. Payment for these services would be set at 80 percent of the lesser of the actual charge or 85 percent of the physician fee schedule amount. The bill also directs the Secretary of Health and Human Services to develop necessary pharmacist-specific codes, with the changes taking effect for services furnished on or after January 1, 2027.
Pharmacy and Medically Underserved Areas Enhancement Act
Introduced in Senate
Read twice and referred to the Committee on Finance.
Health
Pharmacy and Medically Underserved Areas Enhancement Act
USA119th CongressS-2800| Senate
| Updated: 9/15/2025
This legislation, titled the "Pharmacy and Medically Underserved Areas Enhancement Act," proposes to expand Medicare coverage to include specific pharmacist services. It mandates that Medicare Part B cover services furnished by state-licensed pharmacists, provided these services are within their legal scope of practice and would typically be covered if performed by a physician or as incident to a physician's service. A key provision is that these covered pharmacist services must be delivered in designated health professional shortage areas , medically underserved areas, or for medically underserved populations. Payment for these services would be set at 80 percent of the lesser of the actual charge or 85 percent of the physician fee schedule amount. The bill also directs the Secretary of Health and Human Services to develop necessary pharmacist-specific codes, with the changes taking effect for services furnished on or after January 1, 2027.