PharmD · Texas
Collaborative Practice Agreement for Pharmacists in Texas
Yes, a written physician agreement is required. Texas calls it a Written Protocol.
Represents Texas's narrower 'drug therapy management under written protocol' tier (Tex. Occ. Code § 157.101; 22 Tex. Admin. Code § 295.13) — unlike some states' broad collaborative-practice-agreement model, this authority is only available in an FQHC, hospital, hospital-based clinic, or academic health care institution, not an ordinary community pharmacy. The pharmacist may only implement/modify therapy the physician already diagnosed and ordered, not select a new drug independently.
What the collaboration must look like
The rules the physician relationship has to follow. Each fact comes from the statute or board rule listed under sources.
Proximity
Available remotely (no on-site requirement)
22 Tex. Admin. Code § 295.13 permits supervision via direct telecommunication for consultation, assistance, and direction, but ALSO requires the physician be 'geographically located so as to be able to be physically present daily to provide medical care and supervision' — a real geographic constraint beyond pure remote availability, independently corroborated by Tex. Occ. Code § 157.101's 'geographically available for daily medical care' language. Coded TELECOMMUNICATION for the moment-to-moment consultation model, but this daily-physical-presence-capability requirement should not be lost.
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
Annually
The written protocol itself must be reviewed by the physician and pharmacist at least annually and revised as needed — unlike the APRN/PA framework above, no monthly-meeting mandate was found in § 157.101/§ 295.13. Record-retention period for the protocol is 2 years (22 Tex. Admin. Code § 295.13; corroborated by the general Class-A pharmacy retention rule, § 291.34) — a previously-flagged '7th anniversary of expiration' alternative could not be located in any pharmacy rule on a follow-up check and appears to be a confusion with a different (longer) TMB physician medical-record-retention period; dropped as unsupported.
Prescriptive authority
Covered by the practice agreement · no controlled-substance authority
Statute/rule doesn't explicitly address scheduled drugs; this 'follows the physician's own order' structure is read here as not conferring independent controlled-substance prescribing — moderate confidence, flagged as an inference rather than an explicit statutory statement.
Written agreement
Required
Practice ownership (corporate practice of medicine)
Non-licensee ownership permitted — No pharmacist-ownership requirement — Tex. Occ. Code § 560.052 requires only that ownership and the pharmacist-in-charge (PIC)'s license number be disclosed to the Board (disclosure is even waived for publicly-traded companies and pharmacies wholly owned by a retail grocery chain); the PIC retains professional/operational control over dispensing.
Materially more permissive than the medical CPOM rules governing PA/NP/CRNA/CNM/CNS/RN above.
Legal sources for these rules (4)
- Tex. Occ. Code § 157.101 — Delegation to Pharmacist
- 22 Tex. Admin. Code § 295.13 — Drug Therapy Management by a Pharmacist under Written Protocol of a Physician
- Tex. Occ. Code § 560.052 — Ownership Disclosure
- Texas State Board of Pharmacy
What a collaborating physician costs here
Typical monthly cost in Texas
$500 – $600
Estimate for one Pharmacist. Standard-tier state.
About Texas's rules
Texas has no independent-practice pathway for any APRN type (NP/PMHNP/CRNA/CNM/CNS) at any experience level — a 2025 rural 10-year/20,000-hour bill (S.B. 3055) died in committee, as did 2023's full-practice-authority S.B. 1700. No chart-review percentage is codified (the physician and provider set the number themselves) — the commonly-cited 10%/20% figures reflect a pre-2013 rule since repealed. PA is the only non-physician profession with a statutory joint-ownership pathway into a medical entity.
Other clinicians in Texas: see the state overview.