S. 2800
119th CONGRESS 1st Session
To amend title XVIII of the Social Security Act to provide for coverage under the Medicare program of pharmacist services.
IN THE SENATE OF THE UNITED STATES · September 15, 2025 · Sponsor: Mr. Grassley · Committee: Committee on Finance
Table of contents
SEC. 1. Short title
- This Act may be cited as the Pharmacy and Medically Underserved Areas Enhancement Act.
SEC. 2. Medicare coverage of pharmacist services
- (a) Coverage
- Section 1861(s)(2) of the Social Security Act () is amended— 42 U.S.C. 1395x(s)(2)
- in subparagraph (JJ), by inserting at the end;
and- pharmacist services furnished by a pharmacist, as licensed by State law, individually or on behalf of a pharmacy provider—
- (i) which the pharmacist is legally authorized to perform in the State in which the individual performs such services;
- (ii) as would otherwise be covered under this part if furnished by a physician, or as an incident to a physician’s service; and
- (iii) in a setting located in a health professional shortage area (as defined in section 332(a)(1)(A) of the Public Health Service Act), medically underserved area, or medically underserved population (as defined in section 330(b)(3) of such Act);
- pharmacist services furnished by a pharmacist, as licensed by State law, individually or on behalf of a pharmacy provider—
- by adding at the end the following new subparagraph:
- in subparagraph (JJ), by inserting at the end;
- Section 1861(s)(2) of the Social Security Act () is amended— 42 U.S.C. 1395x(s)(2)
- (b) Payment
- Section 1833(a)(1) of the Social Security Act () is amended— 42 U.S.C. 1395l(a)(1)
- by striking
and (HH)and inserting(HH); and - by inserting before the semicolon at the end the following: .
- by striking
- Section 1833(a)(1) of the Social Security Act () is amended— 42 U.S.C. 1395l(a)(1)
- (c) Effective date; Pharmacist specific codes
- (1) Effective date
- The amendments made by subsections (a) and (b) shall apply with respect to services furnished on or after January 1, 2027.
- (2) Pharmacist specific codes
- The Secretary of Health and Human Services shall develop pharmacist specific codes, as necessary, under the physician fee schedule under section 1848 of the Social Security Act (). 42 U.S.C. 1395w–4
- (1) Effective date