• Can a pharmacist independently order and evaluate lab tests (without a CPA)?
    Providing buprenorphine induction and maintenance services may include ordering and evaluating the results of lab tests. This question asks if a pharmacist can perform these functions as a matter of general practice without entering a CPA or protocol with a supervising physician or other healthcare provider.

    To answer this question, LAPPA reviewed the state’s definition of the practice of pharmacy and looked for additional laws and regulations expressly governing pharmacist authority. As compared to the question “Can a pharmacist administer buprenorphine without entering a CPA?”, pharmacy scope of practice laws/regulations more directly include or omit such authorization.

  • Can a pharmacist independently order and evaluate lab tests (without a CPA)?

    • Four states where the answer is “yes” as to lab tests in general; California, Colorado, Idaho, and Washington.

    • 29 states and the District of Columbia where the answer is “yes,” but only as to limited forms of tests that may not cover the types of tests necessary for patients undergoing treatment with buprenorphine. Typically, the provision allows a pharmacist to order CLIA-waived tests and/or tests related to specified illnesses/diseases that do not include OUD; Arkansas, Connecticut, Delaware, Florida, Georgia, Hawaii, Illinois, Iowa, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Vermont, Virginia, the District of Columbia, and Wyoming

    • One state where the authorization would cover only limited forms of tests, but it is unclear if the pharmacist can perform the tests; Alaska.

    • 16 states and Puerto Rico where the answer is “no.”; Alabama, Arizona, Indiana, Kansas, Kentucky, Louisiana, Maine, Mississippi, Missouri, Montana, Nebraska, Oklahoma, Texas, Utah, West Virginia, and Wisconsin. In these states the definition of the practice of pharmacy, as well as all other pharmacy laws/regulations, are silent with respect to lab tests.

    More details about each state’s laws and regulations can be found in the individual state charts.