QUICK REFERENCE GUIDE: PRESCRIPTIONS WHICH MAY BE DISPENSED IN TEXAS Prescription (Rx) Rx information Rx may be Authorized Drug Order Verbal/ Electronic transmitted Written Rx Facsimile transferred refills may be Format: Telephonic (Electronic (outsourced) to a (Paper (Faxed; eFaxed) for initial fill transferred Prescriber Oral/Spoken) Data File) central fill pharmacy Prescription) (i.e., Rx is between Type: Rx Rx* Rx for fulfillment and “on hold”) pharmacies delivery to patient DANGEROUS DRUG RX ISSUED BY: Texas Physician, YES Centrally filled Rx may Dentist,Veterinarian,  Manual signature; or be delivered directly to Podiatrist, or  Electronic replica of YES YES YES YES YES patient or returned to Therapeutic manual signature outsourcer pharmacy (NOTE) printed on secured Optometrists(T &TG) paper, required. for delivery to patient.

Authorized Texas YES  Manual signature; or YES YES YES Centrally filled Rx may Advanced Practice  Electronic replica of Registered Nurse Delegating Delegating Delegating be delivered directly to manual signature patient or returned to (APRN) or Texas Physician Physician Physician YES YES printed on secured outsourcer pharmacy Physician Assistant paper, required; and information information information for delivery to patient. (PA)  Delegating Physician required. required. required. information.

TSBP Authorized Texas YES YES YES  Manual signature;  Manual signature; Centrally filled Rx may Pharmacist  Issued at Hospital,  Issued at Hospital,  Issued at Hospital, be delivered directly to Performing Drug Therapy Hospital-based clinic, Hospital-based clinic, Hospital-based clinic, or Academic health- patient or returned to Management (DTM) or Academic health- NO or Academic health- YES YES care Institution; outsourcer pharmacy care Institution care Institution Under Written Protocol of  Delegating Physician  Delegating Physician  Delegating Physician for delivery to patient. a Physician information information information (1) YES Centrally filled Rx may Out-of-State  Manual signature; or be delivered directly to Physician, Dentist,  Electronic replica of YES YES YES YES YES patient or returned to Veterinarian, or manual signature outsourcer pharmacy Podiatrist printed on secured paper, required. for delivery to patient. YES (1)  Manual signature; or Centrally filled Rx may Out-of-State YES YES YES  Electronic replica of Delegating Delegating Delegating be delivered directly to Advanced Practice manual signature Physician Physician Physician YES YES patient or returned to Registered Nurse or printed on secured information information information outsourcer pharmacy Physician Assistant paper, required; and  Delegating Physician required. required. required. for delivery to patient. information. YES NO Centrally filled Rx may  Manual signature; or NO NO be delivered directly to Canadian or Mexican Including  Electronic replica of Including Including patient or returned to Practitioner authorizations YES YES manual signature authorizations for authorizations for outsourcer pharmacy printed on secured for additional additional refills additional refills for delivery to patient. paper, required. refills CIII-V CONTROLLED SUBSTANCE RX ISSUED BY: Texas Physician, YES YES Centrally filled Rx may Dentist,Veterinarian, YES YES via application If a manually NO on a one- only be returned to Podiatrist, or in compliance Manual signature YES signed paper time basis outsourcer pharmacy Therapeutic with DEA rules (Exception**) (NOTE) required. prescription. for delivery to patient. Optometrists(TG) for EPCS** (Exception***)

YES YES YES YES via application  Manual signature  for a period  If a manually  signed paper in compliance Authorized Texas required; and not to prescription; and with DEA rules YES Centrally filled Rx may Advanced Practice  for a period not to exceed exceed 90 days; 90 days; and  for a period for EPCS**; and NO on a one- only be returned to Registerd Nurse not to exceed and  Delegating  for a period time basis outsourcer pharmacy (APRN) or Physician 90 days; and not to exceed (Exception**)  Delegating Physician (Exception***) for delivery to patient. Assistant (PA) Physician information,  Delegating 90 days; and information, including Physician  Delegating Physician including DEA #. DEA#. information, information, including DEA#. including DEA#. (1) YES YES Centrally filled Rx may Out-of-State YES Physician, Dentist, YES via application in NO on a one- only be returned to Manual signature YES of a manually signed compliance w ith Veterinarian, or time basis outsourcer pharmacy required. paper prescription. DEA rules for (Exception**) Podiatrist EPCS**. (Exception***) for delivery to patient. (1) Out-of-State APRN NO NO NO NO or PA N/A N/A N/A Canadian or Mexican Practitioner NO NO NO NO N/A N/A N/A SCHEDULE II CONTROLLED SUBSTANCE PRESCRIPTIONS (CII Rxs): ● CII Rx may be dispensed only if written on an “official form” provided by the Texas State Board of Pharmacy (TSBP) or if transmitted electronically by a practitioner to a pharmacy in compliance with DEA regulations.** (1) ● CII Rx issued by Out-of-State Practitioners may be filled only by Texas pharmacies that have submitted a plan to TSBP and approved. ● Authorized Texas APRNs/PAs may issue a CII Rx for: 1) a terminally ill patient who is receiving hospice treatment from a qualified hospice provider; or 2) a patient hospitalized for 24 hours or greater, provided that the CII Rx is filled at the in-hospital pharmacy; or 3) a patient receiving emergency services in the hospital’s emergency department, provided that the CII Rx is filled at the in-hospital pharmacy.

* Faxed Rxs – All must include a statement indicating that the Rx has been faxed (e.g.,“Faxed to..”) and name of faxing designated agent, if applicable. ** EPCS = Electronic Prescriptions for Controlled Substances (Code of Federal Regulations, Part 1311). CII-CV EPCS may be electronically “forwarded” for initial fill. *** Exception – Pharmacies electronically sharing a real-time, on-line database may transfer up to the maximum refills permitted by law and the prescriber's authorization. (1) - Includes the United States (other than TX) & U.S.Territories (Puerto Rico, U.S. Virgin Islands, American Samoa, Guam, Northern Mariana Islands). NOTE: For Rx restrictions for Therapeutic Optometrists (T) & Optometric Glaucoma Specialists (TG), visit: www.pharmacy.texas.gov/files_pdf/Optometrists.pdf