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Mar 24, 2017

Pharmacy Immunizations – It’s Far More than Flu Shots

Jeff Hedges, co-host of the Pharmacy Compliance Guide brings us new insights into the Business of Pharmacy & keeping your Community Pharmacy Compliant. This week we focus on Pharmacy Immunizations. 

Can every pharmacists give immunizations?

  • Absolutely, flu is the most recognized but most states will permit pharmacist to provide most immunizations to patients

Are there any restrictions?

  • Yes, each state sets its own requirements for what a pharmacist can administer
  • For example:
    • there are age limits for certain vaccine
    • some vaccine are prohibited by pharmacists to dispense
    • Location of vaccines to be administer

Is there any license requirements?

  • Yes, each states sets its requirements
  • Most states require a separate immunization license
  • Some states have the immunizations within the state issued pharmacist license and scope of practice

Who can administer vaccines in the pharmacy?

  • Licensed pharmacists
  • Registered nurses
  • Licensed interns under the supervision of a pharmacist when permitted by state law

Are there any training requirements?

  • The normal requirements are
  • Complete an American Pharmacist Association approved Immunization course
  • Complete and maintain an American Red Cross or American Heart Association CPR course and certification
  • Maintain state licensure if required

What is needed for Medicare immunizations?

  • I prefer a CMS 855B application for the pharmacy
  • This give the pharmacy the PTAN rather than the pharmacist
  • Submitted through the regional CMS administrator
  • Application fee
  • Separate PTAN is issued

How do you bill for immunizations?

  • It depends on the patients insurance
  • Medicare
    • Using a billing company, such as Change Health or OmniSys 
  • Medicare & Medicaid and Third Party Payor
    • A more robust billing company like TransactRx, Allegiant Billing, Electronic Billing Service
  • Medicare Part C Advantage Plans
    • Bin numbers through the pharmacy software
  • Private payors
    • Bin numbers through the pharmacy software

What other types of immunizations can a pharmacist do?

  • Think outside your box!
    • Contact local businesses
    • Contact local schools and universities
    • Contact local churches and places of worship who are going on mission trips
  • Think different types of immunizations
    • Travel Vaccines
      • International travel requires vaccines
      • Who provides travel vaccines
        • Physicians – No
        • County Department of Health – No
        • Most pharmacies – No
        • You – Absolutely
      • Advantages
        • You can go to churches and other places of worship
        • You can go to businesses who travel internationally
        • Colleges and Universities travel extensively throughout the globe
        • All of these vaccines are CASH!
        • Who sets the price – YOU!
      • Disadvantages
        • You are letting someone else do these immunizations

What type of order is needed to administer a vaccine?

  • Written prescriptions
    • Legal order to administer the vaccine
  • Standing Orders
    • Developed by the CDC and IAC
    • Signed by a physician
    • Should be renewed annually
    • Except in CA and ID where the Pharmacist is now permitted to sign standing orders
  • Emergency Protocols
    • Emergency treatment procedures when a patient has an adverse reaction
    • Signed by a physician
    • Except in CA and ID where the Pharmacist is now permitted to sign standing orders
      • However, I personally recommend that a physician still sign this order to protect the pharmacist

Am I required to have Policies and Procedures?

  • By federal statute, No
  • Strongly recommended by APhA
  • Required to be submitted to the liability carrier when an adverse reaction occurs
  • Check your insurance policy for your compliance requirements

Where do I turn for help and guidance?

  • Well that is where my company comes in
  • We work with the IAC and CDC in developing policies and procedures, standing orders and many other documents
  • All are contained within our Pharmacy Immunization Compliance Program which is maintain as changes occur from the CDC and IAC


R.J. Hedges & Associates

163 9th Street PO Box H  

New Florence, PA 15944  

Phone: (724) 357-8380