Medicare expands to cover pharmacist services, but state rules create access gaps.
S. 2426 — Equitable Community Access to Pharmacist Services Act · Filed by John Thune (R-SD) · 31 cosponsors · Introduced Jul 24, 2025 · Referred to committee
Your members of Congress
Enter a ZIP to see where your representative and both senators stood on this bill.
Looked up on this device — your ZIP is never stored on our servers.
What it does
This bill expands Medicare Part B coverage to include pharmacist services—such as evaluating and treating patients for COVID-19, flu, RSV, strep throat, and other public health emergencies—when performed by a pharmacist working under physician supervision or collaboration as required by state law. Medicare would pay 80% of the lesser of actual charges or 85% of the physician fee schedule (100% for public health emergency services), and pharmacists would be prohibited from balance-billing patients, similar to other Medicare providers.
Why we flagged it
The bill's core mechanism is straightforward: it adds a new category of covered services (pharmacist services) to Medicare Part B and sets payment rates. The operative text directly states what services are covered, under what conditions, and how much Medicare pays.
What the text implies
- Pharmacist scope of practice varies significantly by state; this bill ties Medicare coverage to state law, creating a patchwork where the same service may be covered in one state but not another, potentially creating access inequities across state lines.
- The 85% of physician fee schedule payment rate may be below pharmacists' actual costs in some markets, creating financial pressure on independent pharmacies and potentially favoring large chains with economies of scale.
The full analysis lists 4 implications of this text.
Who stands to gain
pharmacy chains and independent pharmacies; pharmacists and pharmacy service providers; pharmacy benefit managers (PBMs) if they operate in-house pharmacies