Colorado Advanced/Expanded Scope of Practice

CPS prioritizes the optimization of our practice act to utilize pharmacists, technicians, and interns to the top of their education and training. This page is intended to inform our professional community on the expanded and advanced services allowable by law and rule in Colorado.

This page is not exhaustive of all authorities, but simply a highlight of more recent advances, and will be updated as new policies emerge.

For explanation and resources regarding payment/reimbursement for advanced services, please visit our companion webpage CO Provider Status and Payment for Services.

Sources of Practice Information

All Laws – Pharmacists, Pharmacy Business, and Pharmaceuticals Practice Act

“Practice of Pharmacy” Definition (39). (source SB21-094)
“Pharmacist Care Services” Definition (35.5) (source SB21-094)

• All laws that govern our practice are located in the Pharmacists, Pharmacy Business, and Pharmaceuticals Practice Act which is officially in Colorado Revised Statutes (CRS) Title 12, Division of Professions and Occupations, Article 280.
• Specifically, what constitutes the “Practice of Pharmacy” is under Part 1 General Provisions: Definitions 12-280-103 (39), was expanded via the sunset process in 2021 with SB21-094, and is the basis of much of the expanded scope of practice we see in Colorado today.
• Additionally, the old “pharmaceutical care” term was updated and optimized to be “Pharmacist Care Services” Definition (35.5) also in SB21-094.
• Other provisions such as therapeutic substitution and prescription adaptation were also optimized in 2021 and can be found in other part of the Act.
• Finally, all collaborative practice laws are found in Part 6 of the Act.

All Rules

Rules are meant to clarify statutes/laws or provide additional regulatory information to the profession.  They are promulgated through rulemaking with the Board of Pharmacy via a stakeholder process and are officially maintained on the Secretary of State website.  Rules may be located from links on the Board of Pharmacy website.  Always seek the most recent date of Rules when searching on the SOS website.

Board of Pharmacy

Secretary of State 

Collaborative Pharmacy Practice and Statewide Protocols

Collaborative practice in Colorado has two broad categories.

1. Collaborative Practice Agreements
1. Law - Part 6 of the Pharmacists, Pharmacy Business, and Pharmaceuticals Practice Act.
2. Rules - Board Rule 17.00.
3. Collaborative Drug Therapy Management (CDTM)
• “Collaborative drug therapy management” (CDTM) is a collaborative practice agreement involving a higher level of disease complexity and/or decision making.
• Rule 17 has specific sections that apply only to CDTM.

• Sample templates 
• Diabetes Collaborative Practice Agreement (DM CPA)
• Hypertension Collaborative Practice Agreement (HTN CPA) (Coming Soon)
1. Statewide Protocols (SWP)
1. Law Part 6 of the Pharmacists, Pharmacy Business, and Pharmaceuticals Practice Act.
2. Rules - 17.00.50
3. Appendices
1. Hormonal contraception
2. Smoking cessation
3. PrEP/PEP
4. Statin therapy
4. Potential reimbursement: CO Provider Status and Payment for Services
5. Training and Resources
1. Statewide Protocol CPS Training and Resources Webpage

Pharmacists Independent Prescribing Authority

In specific instances, pharmacists in CO have independent prescriptive authority. Much of this was established in the Pharmacy Practice Sunset bill (SB21-094). Pharmacists should only practice commensurate with clear education and training in this category.  The following are allowed instances of independent prescriptive authority by pharmacists in Colorado: 

• Medicaid OTC medications – See “Covered Pharmacist Services: Prescribing OTCs” Pharmacist Services Billing Manual | Colorado Department of Health Care Policy & Financing
• Medicaid prescribing of Paxlovid () (source: See “Covered Pharmacist Services: Prescribing of Paxlovid” Pharmacist Services Billing Manual | Colorado Department of Health Care Policy & Financing
• Statewide Protocols (SWPs) State Board of Pharmacy: Laws and Rules | Division of Professions and Occupations (colorado.gov)
1. Hormonal Contraception
2. Smoking Cessation
3. HIV PrEP/PEP
4. Statin Therapy
• Naloxone (in addition to the option of using the statewide standing order) (source: 12-280-103 (39))
• Medications for conditions that don’t require a new diagnosis (source: 12-280-103 (39))
• Medications for conditions that are minor/self-limiting (source: 12-280-103 (39)) (source: 12-280-103 (39))
• Medications for conditions that have a CLIA-waived diagnostic test. (source: 12-280-103 (39))

Vaccination Authority

1. Pharmacists
1. Rules - Pharmacy Rules 19.00.00 (Administration) and 19.01.00 (Vaccines and Immunizations)
2. Technicians
1. Law -  Pharmacists, Pharmacy Business, and Pharmaceuticals Practice Act

1. Section 12-280-103-Definitions

1. 38.5 (VIII)-Other activities as authorized and defined by the board by rule
2. Rules - Pharmacy Rules 19.00.00 (Administration) and 19.01.00 (Vaccines and Immunizations)

Pharmacists Administration of Medications Authority

Laws- Pharmacists, Pharmacy Business, and Pharmaceuticals Practice Act

Section 12-280-103. (1) “Administer” means the direct application of a drug to the body of a patient or research subject by injection, inhalation, ingestion, or any other method.

Technician Scope of Practice:

Prior to 2019, technicians did not have a legally defined scope of practice and were not regulated in any way in Colorado. With the passage of HB19-1242, technician practice was defined and has been refined both in law and rule since.

Law  -  Pharmacists, Pharmacy Business, and Pharmaceuticals Practice Act -Section 12-280-103-Definitions (38.5)

For Technician Vaccine Scope of Practice, please see Vaccination Authority section above

Additional Resources

• CPS CE Webinar: Do You Know What You Don’t Know? The Scope of Scope and Status of Provider Status
• Point-of-Care Test & Treat Resources

• A Guide to Implementing POCT Services in Community Pharmacy
• NASPA Pharmacy-Based Point-of-Care Test & Treat National Certificate Program

 CONTACT US!

We are always striving to advance reimbursement and payment for pharmacy professional services in Colorado. Please email us with thoughts, needs, challenges, etc. [email protected].