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State-by-State Guide to Physician Dispensing Regulations*

Physician dispensing is regulated at the state level, leading to a wide range of rules. The American Medical Association supports this practice when it benefits patients and adheres to ethical standards (AMA Policy).

 

Consequently, many states allow physician dispensing, though the specific requirements differ. These can include dispensing under a medical license, or requiring permits for controlled substances or all legend drugs.

 

To assist you in understanding these differences, Advanced Rx has compiled reference information on state by state in office physician dispensing regulations, and we have provided by state links where available.

 

Disclaimer: This information is for guidance only. Always verify your dispensing eligibility and ensure compliance with all state and federal regulations by consulting with legal counsel and your state medical or pharmacy board.

Dispensing map_edited.jpg

AL

Alabama Physician Dispensing Guidelines 

  • Who Can Dispense?

    • MDs and DOs can dispense. Your state medical license allows you to dispense medications to your patients in Alabama.

  • No permit for non-controls. You do not need a special dispensing permit for regular prescription medications.

  • Permit needed for controls ($100). If you plan to dispense controlled substances, a $100 permit is required.

  • PAs/RNs cannot dispense controls. Please note that Physician Assistants and Registered Nurses cannot dispense controlled medications.

  • Official Rules: For the comprehensive regulations, see: 

  • https://www.albme.gov/uploads/forms/dispreg.pdf

AK

Alaska Physician Dispensing 

  • Who Can Dispense?

    • Physicians in Alaska can dispense medications directly to their patients.

  • Important Restrictions:

    • Physicians cannot present themselves as pharmacists or imply they have an on-site pharmacy.

    • They must follow all relevant professional and ethical guidelines.

    • They are required to provide prescription counseling to patients.

  • Notification: Physicians must inform the Alaska Composite Medical Board before they start dispensing medications.

  • Permit: No specific dispensing permit is required.

  • Permit Link: Not applicable.

  • Alaska Composite Medical Board: https://www.commerce.alaska.gov/web/cbpl/professionallicensing/statemedicalboard.aspx

AZ

Arizona Physician Dispensing 

AR

Arkansas Physician Dispensing 

Dispensing in Arkansas: Proceed with Caution. While physician dispensing is technically allowed in Arkansas, obtaining the necessary permit is often impractical. The state requires physicians to prove a specific need to dispense certain prescription medications to their patients, typically citing issues like patient difficulty in getting the drug or significant distance to a pharmacy.

Permit Required: Yes

Detailed Rules:

https://www.armedicalboard.org/Professionals/pdf/Dispensing%20Application%20with%20Rules%20and%20Regulations.pdf

CA

California Physician Dispensing

  • Who Can Dispense?

    •  MDs and DOs can dispense directly. PAs and RNs can dispense under the supervision of an MD or DO. Nurse practitioners can hand pre-packaged, labeled medications to patients.

  • Is it Legal? Yes, California law (Pharmacy Law Article 12, Section 4170) explicitly allows physicians to dispense legend drugs to their own patients under their medical license, following specific labeling rules.

  • Permit Needed? No specific dispensing permit is required for physicians.

​

While legally allowed, the financial viability of physician dispensing in California depends heavily on the specific fee schedules and your practice's costs. You'll need to investigate the reimbursement rates to make an informed decision.

CO 

Colorado Physician Dispensing

  • Who Can Dispense?

    • MDs, DOs, DPMs, and PAs (under physician protocols and supervision).

  • Limited: NPs can dispense only prepackaged drugs under specific protocols.

  • No: RNs cannot dispense.

  • Legal Basis: Explicitly allowed in Colorado Revised Statute Title 12, Article 42.5, Section 118. This law permits practitioners to personally compound and dispense drugs they are authorized to prescribe to their own patients when deemed necessary for treatment.

  • Permit/Registration: No general permit or registration is required for physician dispensing in Colorado.

  • Controlled Substances: Physicians dispensing controlled substances must have a valid DEA registration.

CT

Connecticut Physician Dispensing

DE

Delaware Physician Dispensing

  • Who Can Dispense?

    • Medical Doctors (MDs)

    • Doctors of Osteopathic Medicine (DOs)

    • Physician Assistants (PAs)

    • Registered Nurses (RNs)

  • Permit Required?

    • No dispensing permit is needed in Delaware.

  • Controlled Substances:

    • Practitioners (MDs, DOs, PAs, NPs) who want to dispense controlled substances must:

      • Apply for a Delaware Controlled Substances Registration.

      • Maintain an active DEA (Drug Enforcement Administration) registration.

  • Rules and Regulations:

    • It's recommended to consult the official Delaware Board of Medical Licensure and Discipline website for the most up-to-date rules and regulations regarding dispensing practices. You can likely find relevant information under their statutes and regulations sections.

FL

Florida Physician Dispensing

GA

Georgia Physician Dispensing

  • Who can dispense?

    • Physicians in Georgia may dispense legend drugs to their patients without a permit, but only after notifying the Georgia Composite Medical Board in writing of their intent to act as a dispensing physician. 

  • Notification: Physicians must notify the Georgia Composite Medical Board (GA CMB) in writing of their intent to dispense legend drugs (prescription medications) to their patients (beyond just samples).

    • How to Notify: Send a letter to the GA CMB or indicate this intent on your license renewal form.

    • Important Note: The GA CMB will then share this information with the Georgia Pharmacy Board and the Georgia Drugs and Narcotics Agency (GDNA).

    • Confirmation: No confirmation letter is sent. It's recommended to send your notification to the GA CMB via certified mail with return receipt requested for your records.

  • Rules and Regulations: You'll need to consult the official rules and regulations of the Georgia Composite Medical Board and the Georgia Pharmacy Board for complete details on dispensing requirements and limitations.

​

Key Takeaway: Notify the GA CMB in writing before dispensing legend drugs (other than samples). Keep proof of your notification.

 

 

Permit: Not required.

HI

Hawaii Physician Dispensing

ID

Idaho Physician Dispensing

  • Who can dispense?

    • In Idaho, licensed physicians can dispense legend drugs directly to their patients. This is allowed under Idaho Revised Statutes § 37-2722.

  • Key Points:

    • The physician must be acting within the rules of their medical license when writing the prescription.

    • Physicians need to apply for and receive a Prescriber Drug Outlet Registration.

    • There is a small fee associated with this registration.

    • Permit Required: Yes (Prescriber Drug Outlet Registration)

    • Permit Link: Prescriber Drug Outlet Registration application from the Idaho Board of Pharmacy - https://dopl.idaho.gov/bop/bop-forms/

  • Recommended Rules and Regulations:

​

Important Note: Always refer to the official Idaho statutes and the Idaho Board of Pharmacy website for the most up-to-date and accurate information.

IL

Illinois Physician Dispensing

  • Who can dispense?

    • Can physician's dispense non-controlled drugs? Yes, under your medical license, following all state and federal laws.

    • What about controlled substances? You need a separate license from the IDFPR ($5 per dispensing location).

  • Rules and Regulations: https://www.idfpr.com/profs/contsub.asp

IN

Indiana Physician Dispensing

  • Who can dispense?

    • Indiana physicians, nurse practitioners, and physician assistants can dispense legend drugs under the Indiana Legend Drug Act (IC 16-42-19), provided they comply with all state and federal regulations, including labeling and reporting. Dispensing controlled substances requires a Controlled Substance Registration (CSR) from the Indiana Professional Licensing Agency and a federal DEA registration. Regulations also specify requirements for controlled substance prescriptions, such as the use of security feature prescription paper. For the most current and complete information, please refer to the Indiana Board of Pharmacy and the Indiana Board of Medicine.

  • Useful Links:

IA

Iowa Physician Dispensing

  • Who can dispense?

    • Iowa physicians are permitted to dispense non-controlled prescription medications (legend drugs) within their scope of practice. All standard labeling and state/federal regulations must be adhered to.

    • To dispense controlled substances, physicians must obtain a controlled substance registration permit from the state and pay a fee.

  • Controlled Substance Permit Required: Yes

  • Permit Fee: $90 (every two years)

  • Detailed Rules & Regulations: Available at 

KS

Kansas Physician Dispensing

  • Who can dispense?

    • In Kansas, licensed Medical Doctors (MDs), Doctors of Osteopathic Medicine (DOs), and Physician Assistants (PAs) are authorized to dispense non-controlled legend drugs directly to their patients. This is permitted as long as all applicable state and federal laws and labeling standards are strictly followed. No separate dispensing permit is necessary.

KY

Kentucky Physician Dispensing

  • Who can dispense?

    • Kentucky physicians can dispense medications they are authorized to prescribe.

    • Dispensing cannot be delegated to PAs, NPs, or staff.

    • No dispensing license is required.

LA

Louisiana Physician Dispensing

  • Who can dispense?

    • In Louisiana, physicians must register as dispensing physicians and pay a $75 registration fee to dispense medications. If dispensing controlled medications, the supply is limited to a maximum of 48 hours. It's important to read the Louisiana State Board of Medical Examiners' dispensing rules before applying for a permit. Note that Advance Practice Registered Nurses (APRNs) are permitted to distribute prepackaged medications to patients.

  • Dispensing Permit Required: Yes Permit Fee: $75

  • Link to Dispensing Rules: http://www.lsbme.la.gov/content/application-instructions-initial-licensure-dispensing-permit

ME

Maine Physician Dispensing

  • Who can dispense?

    • Maine physicians with a valid state medical license can dispense medications.

  • Permit required?
    • No specific dispensing permit is needed.

​

  • Important Reminders:

    • All state and federal rules for proper medication storage and labeling must be followed.

    • Registered Nurses (RNs) can dispense controlled substances, but only under the direct supervision of a physician.

  • ​Rules and Regulations: You should consult the Maine Board of Licensure in Medicine website for the most up-to-date regulations. Look for sections related to physician responsibilities and medication dispensing. https://www.maine.gov/md/home

MD

Maryland Physician Dispensing

MA

Massachusetts Physician Dispensing

  • Who can dispense?

    • Massachusetts law restricts physician dispensing to a single dose or the amount needed for immediate use. Due to this limitation, routine dispensing by physicians is generally not feasible.

​

Advanced Rx Mail Order Pharmacy Services is a good option in this state.

MI

Michigan Physician Dispensing

  • Who can dispense? 

    • In Michigan, MDs, DOs, DPMs, DDSs, and PAs are authorized to dispense medications. However, all practitioners who dispense, even non-controlled legend drugs, must first obtain a Drug Control License and pay a fee ranging from $48 to $90 (depending on the license expiration date).

  • For dispensing controlled substances, a separate Controlled Substance License is also necessary, with a fee of $90 to $120 (depending on expiration).

  • Important Note for Mid-Level Providers (NP, PA): Dispensing is limited to a 72-hour supply.

  • Required Permit: Drug Control License (and Controlled Substance License if dispensing controlled substances)Associated Fees: $48-$90 (Drug Control), $90-$120 (Controlled Substance)

  • Full Regulations: https://www.michigan.gov/-/media/Project/Websites/lara/bpl/Folder10/Drug_Control_Final.pdf?rev=087ca16f52c3446d9e0794436db8611d

MN

Minnesota Physician Dispensing

  • Who can dispense? 

    • Minnesota physicians authorized to prescribe legend drugs.

  • Permit needed? No dispensing permit is required for non-controlled or controlled medications.

  • Requirements: Compliance with all state and federal laws, including labeling and PDMP reporting.

  • Dispensing for Profit: Requires completion and submission of the "Dispensing Drugs for Profit" form to the Minnesota Board of Medical Practice.

  • Full Regulations: https://mn.gov/boards/assets/Dispense_Drugs_For_Profitr_Report_Form-2009-10.pdf_tcm21-36590.pdf

MS

Mississippi Physician Dispensing

  • Who can dispense? 

    • Favorable State: Mississippi is considered a very favorable state for physician dispensing.

    • No Separate Permit: Physicians in Mississippi do not need a separate permit to dispense medications, including controlled substances.

    • NPs and PAs: Nurse Practitioners (NPs) and Physician Assistants (PAs) are also authorized to dispense under their existing licenses.

  • Compliance Required: All dispensing practitioners (physicians, NPs, and PAs) must still follow all applicable Mississippi state and federal laws and regulations.

  • Dispensing Permit Required: No

  • Permit Link: N/A (No permit required)

  • Rules and Regulations:

    • For specific Mississippi laws and regulations related to healthcare professionals and dispensing, it's recommended to consult the official websites of the following:

    • Mississippi State Board of Medical Licensure: This board oversees physicians and may have relevant regulations.

    • Mississippi Board of Nursing: This board oversees Nurse Practitioners and may have relevant dispensing regulations.

    • Mississippi State Board of Medical Licensure (for PAs): This board also oversees Physician Assistants and their scope of practice, including dispensing.

    • Mississippi Board of Pharmacy: While a separate dispensing permit isn't required, the Board of Pharmacy sets regulations for pharmacies and may have overlapping rules regarding medication handling, labeling, and record-keeping that dispensing practitioners must adhere to.

  • Additionally, all practitioners must comply with relevant federal regulations related to drug dispensing, particularly for controlled substances (e.g., DEA requirements).

MO

Missouri Physician Dispensing

  • Who can dispense? 

    • Physicians and Physician Assistants with an established patient relationship.

  • Controlled Medications: Require a separate license from the Missouri Bureau of Narcotics and Dangerous Drugs ($30 fee).

  • Regulations: For complete details, refer to:: https://health.mo.gov/safety/bndd/pdf/580-3014.pdf

MT

Montana Physician Dispensing

  • Who can dispense?  

    • Montana physicians can now dispense legend drugs directly to their own patients under a new law effective May 12, 2021. However, they cannot dispense controlled substances. To dispense, physicians must register as a dispenser with the Montana Board of Pharmacy.

  • Dispensing Allowed: Legend drugs to own patients.

  • Dispensing Prohibited: Controlled substances.

  • Action Required: Register as a dispenser with the MT Board of Pharmacy.

  • Regulations: https://ebiz.mt.gov/POL/Default.aspx?pk_vid=deb030d99b7bea881647039016fb9ea4

NE

Nebraska Physician Dispensing

  • Who can dispense?  

    • Nebraska physicians need a pharmacy permit to dispense medications.

  • Do I need a permit? Yes

  • What is the permit fee? $625

  • What can I dispense? Any medication you are legally allowed to prescribe, provided you follow all Nebraska and federal regulations.

  • Where can I find the rules? 

NV

Nevada Physician Dispensing

NH

New Hampshire Physician Dispensing

  • Who can dispense?  

    • Good news for NH physicians! You can dispense medications directly to your patients without needing a separate dispensing permit. This is covered under your state medical license.

  • Important Limits for Controlled Substances:

    • Schedule II Medications: Dispensing is limited to a 48-hour supply.

    • Schedule III, IV, and V Medications: Dispensing is limited to a 7-day supply.

NJ

New Jersey Physician Dispensing

​

Advanced Rx Mail Order Pharmacy Services is a good option in this state.

NM

New Mexico Physician Dispensing

  • Who can dispense? 

    • Non-Controlled Legend Drugs: Physicians can dispense these with proper labeling (date, Rx#, physician/clinic info, patient name, drug info, directions, expiration) and secure storage.

    • Controlled Substances (Schedules II-V): Require a separate registration with the New Mexico Board of Pharmacy ($60 annual fee per location).

  • Controlled Substance Registration: Requires a completed application to the Board of Pharmacy and a valid DEA registration for each dispensing location.

    • Controlled Substance Record Keeping: Strict inventory and records (receipt, dispensing, administration, disposal) are mandatory, kept for at least three years, with annual inventory. Separate Schedule I & II records required.

    • Prescription Monitoring Program (PMP): Reporting of dispensed controlled substances is required at least every seven days.

    • Controlled Substance Security: Implement measures to prevent theft/diversion; report loss/theft to the NM Board of Pharmacy within 5 days and DEA within 1 day.

    • Labeling: Required for all dispensed drugs (see full description for details).

    • Storage: Medications must be stored securely and under proper conditions.

  • Key Actions for Dispensing Controlled Substances:

    • Apply for a New Mexico Board of Pharmacy controlled substance registration ($60/year).

    • Obtain a DEA registration for each dispensing location.

    • Implement strict inventory and record-keeping procedures.

    • Report dispensing data to the New Mexico PMP.

    • Establish secure storage for controlled substances.

​

Important Note: This is a simplified summary. Always refer to the New Mexico Regulation and Licensing Department and the New Mexico Board of Pharmacy for complete and updated regulations.

NY

New York Physician Dispensing

  • Who can dispense? 

    • Physicians in NY can dispense medication, but typically for no more than a 72-hour supply. There are specific situations where this limit may not apply.

  • A separate dispensing permit is not required.​

  • Permit: Not required.

  • Official Rules & Regulations:

​

Advanced Rx Mail Order Pharmacy Services is a good option in this state.

NC

North Carolina Physician Dispensing

  • Who can dispense? 

    • In North Carolina, Medical Doctors (MDs), Doctors of Osteopathic Medicine (DOs), Physician Assistants (PAs), and Nurse Practitioners (NPs) are permitted to dispense medications. This requires applying for and receiving a Dispensing Physician Registration with the state.

    • Additionally, PAs and NPs who dispense medications based on their own prescriptions must also obtain a dispensing permit.

    • To register as a dispensing physician in North Carolina, physicians must first create a profile on the Board's Licensure Gateway, then submit a Dispensing Physician Registration application with a $75 fee, and upload a sample dispensing label. 

  • Dispensing Permit: Required (for all dispensing practitioners)

  • Key Resource: North Carolina Board of Pharmacy - Dispensing Physician Registration Requirements

ND

North Dakota Physician Dispensing

  • Who can dispense? 

    • North Dakota has very straightforward rules for physicians who want to dispense medications directly to their patients.

  • No Special Permit Needed: Unlike many other states, you do not need a separate permit to dispense as a physician in North Dakota.

  • Helpful Guide: The North Dakota Board of Pharmacy offers excellent guidance in their "Administrative Guidelines for Practitioner Dispensing in North Dakota."

  • NPs and PAs: Nurse Practitioners (NPs) and Physician Assistants (PAs) can also dispense medications if a supervising prescriber approves.

OH

Ohio Physician Dispensing

  • Who can dispense? 

    • Physicians in Ohio can dispense medications. However, most will need a Terminal Distributor of Dangerous Drugs (TDDD) license (covers all prescription drugs). While sole practitioners may have exceptions, a TDDD license is generally required. Dispensing controlled substances is heavily restricted in quantity and usually impractical. A separate TDDD Controlled Substances license is needed for dispensing controlled substances.

  • Permit: Yes (TDDD license generally required)

  • Rules & Regulations: https://elicense.ohio.gov/OH_HomePage

OK

Oklahoma Physician Dispensing

  • Who can dispense? 

    • MDs: Yes, after registering with the state medical board (no fee). Indicate "Yes" to dispensing during online license renewal.

    • DOs: Yes, but require a dispensing permit ($50 per location). Can add during online license renewal.

    • PAs: No.

    • APRNs & RNs: No.

  • Registration/Permit Required: Yes (see above).

  • Permit Cost: $50 per location for DOs (part of license renewal or online).

  • More Information: http://www.oar.state.ok.us/viewhtml/510_10-7-1.htm

  • Relevant Law: Title 59 sec 353.1

OR

Oregon Physician Dispensing

PA

Pennsylvania Physician Dispensing

  • Who can dispense? 

    • PA-licensed physicians can dispense to their patients.

  • Limit: 30-day supply max (7 days for Schedule II/III drugs).

  • Compliance: All state and federal dispensing regulations apply.

  • Dispensing Permit: Not needed.

  • Pennsylvania State Board of Medicine: This is the primary regulatory body for physicians in PA. Look for sections on prescribing and dispensing.

​

Refills are not allowed and therefore in-office dispensing in this state is very limited.   

​

Advanced Rx Mail Order Pharmacy Services is a good option in this state.

RI

Rhode Island Physician Dispensing 

  • Who can dispense?

    • Physicians authorized to prescribe medications in Rhode Island.

  • What can they dispense? Medications to their own patients as part of their regular medical practice.

  • Additional Permit/License Required? Not, generally.

  • Controlled Substances: Physicians who want to dispense controlled medications must register with the state.

  • Permit Information: Registration for controlled substances is required (CSR $200).

  • Rules & Regulations:

SC

South Carolina Physician Dispensing 

  • Who can dispense?

    • Physicians can dispense medications to their own patients in South Carolina.

    • Nurse Practitioners can also dispense but have their own specific rules.

  • A dispensing permit is needed if you dispense medications at any location that you don't directly and fully own.

  • A separate controlled substance license is required from the state if you want to dispense controlled medications.

  • Rules and Regulations:

SD

South Dakota Physician Dispensing 

  • Who can dispense?

    • Physicians can dispense, if the patient is under their care.

    • What about NPs and PAs? They can dispense if their supervising physician specifically allows it.

  • What's needed?

    • Complete a controlled substances registration form.

    • Pay a small fee (currently $150).

  • Permit Required : Yes

  • Permit Cost: $150

  • Rules and Regulations: 

TN

Tennessee Physician Dispensing 

  • Who can dispense?

    • Tennessee physicians can dispense medications to their own patients.

  • Permit Required: No

  • All state and federal regulations must be followed (e.g., storage, labeling).

TX

Texas Physician Dispensing 

  • In Texas, physicians generally cannot dispense medications directly to patients. There are a few exceptions, notably for rural clinics. No permit or further rules/regulations details are available at this time.

​

Advanced Rx Mail Order Pharmacy Services is a good option in this state.

UT

Utah Physician Dispensing 

  • UT Physician Dispensing: Prohibited in Utah, except in limited circumstances. No permit required or specific regulations available.

VT

Vermont Physician Dispensing 

  • Who can dispense?

    • In Vermont, licensed physicians can dispense medications to their own patients. No extra license is needed. They must follow all standard drug storage and labeling regulations (state and federal).

    • Nurse Practitioners (NPs) and Physician Assistants (PAs) can dispense if a supervising physician has delegated this task.

VA

Virginia Physician Dispensing 

  • Who can dispense? 

    • Virginia physicians can dispense medications directly to their patients in-office. However, this requires obtaining a dispensing license from the state, regardless of whether the medication is controlled or non-controlled.

  • Key Requirements:

    • A dispensing license is mandatory for each physician who wishes to dispense.

    • The physical location where dispensing occurs must also be licensed.

    • Physicians must be present on-site during dispensing.

    • They are responsible for offering patient counseling and inspecting the medication.

    • Pharmacy technicians, nurse practitioners, or physician assistants can assist with preparation.

    • Licensed dispensing facilities may be subject to inspections.

  • Permit: Required Permit Fee: $0 - $315

  • Regulations:

  • Online Application:

WA

Washington Physician Dispensing 

  • Who can dispense? 

    • Eligible Prescribers: MDs, DOs, DPMs, PAs, and NPs can dispense.

  • General Rule: Washington has favorable regulations allowing in-office dispensing to your own patients.

  • Permit: Not required for in-office dispensing.

WV

West Virginia Physician Dispensing 

  • Who can dispense? 

    • West Virginia physicians are permitted to dispense medications to their patients.

  • Controlled Substances: To dispense controlled substances, a Controlled Substance Dispensing Practitioner Registration is necessary, with a fee of $30.

  • Dispensing Guidelines: Medications can only be dispensed to patients the physician is actively treating and must occur during an office visit.

  • Required Patient Notification: Physicians must display a clearly visible sign (at least 8.5 x 11 inches) with the following statement: "Every patient has the right to receive a written prescription as an alternative to having legend drugs dispensed by your physician."

  • Registration Cost: $30

  • Full Regulations:

WI

Wisconsin Physician Dispensing 

  • Who can dispense? 

    • Wisconsin is physician-dispensing friendly. No extra permits, licenses, or fees are needed for doctors to dispense both controlled and non-controlled medications to their patients under their care. Refer to the standards for dispensing and prescribing drugs for details.

WY

Wyoming Physician Dispensing 

  • ​Wyoming does not allow physician dispensing outside of rare exceptions.

DC

Washington D.C. Physician Dispensing

  • Who can dispense?

  • Physicians can dispense medications in their office.

  • A Controlled Substances Registration (CSR) is needed to dispense controlled drugs ($130 fee).

  • Rules and regulations: 

Assorted medication blister packs

Important Notice

*The physician dispensing regulations and rules referenced herein are provided by Advanced Rx Management (Advanced Rx) for general guidance only, based on research current as of March 25, 2025. Due to the dynamic nature of state laws, this information may not be up-to-date. It is crucial to consult directly with an attorney or your state medical or pharmacy board to verify the latest regulations and determine your authority to dispense. Furthermore, regulations concerning dispensing by mid-level practitioners (Physician Assistants and Nurse Practitioners) can vary considerably from physician dispensing rules on a state-by-state basis.

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