PRIA Logo™
119-s-2426119th CongressWALLET

Equitable Community Access to Pharmacist Services Act

Sponsored By: Senator Thune, John [R-SD]

Introduced

Summary

Medicare coverage for pharmacist services. This bill would add pharmacist services to Medicare Part B, define which pharmacist services qualify, set payment rules, require collaboration with physicians under State law, and bar balance billing, effective January 1, 2026.

Show full summary
  • Seniors and Medicare enrollees would get Part B coverage for pharmacist visits that evaluate, test, or treat COVID-19, influenza, RSV, or streptococcal pharyngitis and for other pharmacist testing or treatment tied to a declared public health emergency. Coverage applies to items and services furnished on or after Jan. 1, 2026.
  • Pharmacists would become a defined Part B provider category with a specified collaboration process for working with physicians or practitioners under State law and related scope‑of‑practice rules. The bill adds pharmacists to the list of providers banned from balance billing.
  • Payment rules would tie pharmacist reimbursement to the physician fee schedule. Medicare would pay 80% of the lesser of the actual charge or a percentage of the fee‑schedule amount, normally 85% and 100% for services addressing a public health need.

Personalized for You

How does this bill affect your finances?

Personalize government policy and PRIA will tell you what this bill means for your household, plus every other piece of legislation we track. PRIA reads each provision against your financial profile to show you exactly what matters to your wallet.

Free to download

Bill Overview

Analyzed Economic Effects

1 provisions identified: 0 benefits, 0 costs, 1 mixed.

Medicare coverage for pharmacist services

If enacted, Medicare Part B would cover a new category called "pharmacist services" starting January 1, 2026. Pharmacists could bill for services they are legally authorized to provide under State law, and they must follow any State-required supervision or collaboration rules. Medicare payment would be 80% of the lesser of the billed charge or 85% of the physician fee amount (100% of that amount for services tied to a declared public-health emergency). Pharmacists would also be prohibited from balance-billing Medicare patients for these covered services. Covered services explicitly include visits for testing or treatment for COVID-19, influenza, RSV, and streptococcal pharyngitis, and other testing or treatment tied to a declared public-health emergency as determined by the Secretary.

Sponsors & CoSponsors

Sponsor

Thune, John [R-SD]

SD • R

Cosponsors

  • Sen. Kelly, Mark [D-AZ]

    AZ • D

    Sponsored 9/29/2026

  • Sen. Warner, Mark R. [D-VA]

    VA • D

    Sponsored 7/24/2025

  • Sen. Tillis, Thomas [R-NC]

    NC • R

    Sponsored 7/24/2025

  • Sen. Daines, Steve [R-MT]

    MT • R

    Sponsored 7/24/2025

  • Sen. Hassan, Margaret Wood [D-NH]

    NH • D

    Sponsored 7/24/2025

  • Sen. Warren, Elizabeth [D-MA]

    MA • D

    Sponsored 7/24/2025

  • Sen. Welch, Peter [D-VT]

    VT • D

    Sponsored 7/24/2025

  • Sen. Cortez Masto, Catherine [D-NV]

    NV • D

    Sponsored 7/24/2025

  • Sen. Lankford, James [R-OK]

    OK • R

    Sponsored 7/30/2025

  • Sen. Blunt Rochester, Lisa [D-DE]

    DE • D

    Sponsored 9/3/2025

  • Sen. Cramer, Kevin [R-ND]

    ND • R

    Sponsored 9/3/2025

  • Sen. Klobuchar, Amy [D-MN]

    MN • D

    Sponsored 9/9/2025

  • Sen. Sullivan, Dan [R-AK]

    AK • R

    Sponsored 9/9/2025

  • Sen. Heinrich, Martin [D-NM]

    NM • D

    Sponsored 9/17/2025

  • Sen. Shaheen, Jeanne [D-NH]

    NH • D

    Sponsored 9/17/2025

  • Sen. Capito, Shelley Moore [R-WV]

    WV • R

    Sponsored 9/17/2025

  • Sen. Fischer, Deb [R-NE]

    NE • R

    Sponsored 9/17/2025

  • Sen. Murkowski, Lisa [R-AK]

    AK • R

    Sponsored 10/7/2025

  • Sen. Kaine, Tim [D-VA]

    VA • D

    Sponsored 10/7/2025

  • Sen. Coons, Christopher A. [D-DE]

    DE • D

    Sponsored 10/8/2025

  • Sen. Rounds, Mike [R-SD]

    SD • R

    Sponsored 10/8/2025

  • Sen. Schiff, Adam B. [D-CA]

    CA • D

    Sponsored 10/14/2025

  • Sen. Kennedy, John [R-LA]

    LA • R

    Sponsored 10/14/2025

  • Rep. Mullin, Markwayne [R-OK-2]

    OK • R

    Sponsored 10/16/2025

  • Sen. Marshall, Roger [R-KS]

    KS • R

    Sponsored 10/22/2025

  • Sen. Blackburn, Marsha [R-TN]

    TN • R

    Sponsored 11/20/2025

  • Sen. Peters, Gary C. [D-MI]

    MI • D

    Sponsored 11/20/2025

  • Sen. Whitehouse, Sheldon [D-RI]

    RI • D

    Sponsored 12/2/2025

  • Sen. Collins, Susan M. [R-ME]

    ME • R

    Sponsored 2/9/2026

  • Sen. Murray, Patty [D-WA]

    WA • D

    Sponsored 2/9/2026

  • Sen. McCormick, David [R-PA]

    PA • R

    Sponsored 6/16/2026

  • Sen. Merkley, Jeff [D-OR]

    OR • D

    Sponsored 6/16/2026

  • Sen. Cornyn, John [R-TX]

    TX • R

    Sponsored 9/23/2026

Roll Call Votes

No roll call votes available for this bill.

View on Congress.gov
Back to Legislation