CPA for Vaccines - FAQs

A CPA is a physician-signed, state-specific agreement that authorizes pharmacists to administer vaccines according to an approved protocol without needing individual prescriptions.

Outcomes manages:

• Physician relationships
• Contracting and signatures
• Protocol updates

This allows pharmacies to focus on delivering patient care.

CPA Coverage FAQs:

What does the Vaccine CPA allow my pharmacy to do?

The CPA allows pharmacists to:

• Administer vaccines permitted under state law
• Generate prescriptions using the CPA physician as the authorizing provider
• Deliver immunization services without obtaining individual prescriptions

What states have the CPA available?

Outcomes currently offers Vaccine CPAs in 39 states. Please refer to the CPA Coverage Map for the full list of participating states. 

Which providers are covered under the CPA?

The CPA covers:

• Licensed pharmacists
• The following providers may be covered, where allowed by state law, under the direct supervision of a licensed pharmacist in good standing:
  • Pharmacy interns (where allowed by state law)
  • Pharmacy technicians (where allowed by state law)
  • Pharmacy students (where allowed by state law)

No other healthcare providers are authorized under the Outcomes CPA program.

Can technicians administer vaccines under the CPA?

This depends on state law, not the CPA itself.

• In states where technicians are permitted to administer vaccines, pharmacists may delegate administration
• Pharmacists remain responsible for oversight and clinical decision-making

For state-specific guidance, pharmacies should refer to their state board of pharmacy

Are nurses covered under the CPA?

No. Only pharmacists (and interns, students, or technicians, where allowed) are authorized to act under the CPA. Outcomes does not current offer Collaborative Practice Agreements for nursing providers.

Which vaccines are covered by the CPA?

The CPA covers routine immunizations authorized by state, federal, and local governing bodies.  

Does the CPA cover vaccines for children?

This varies by state; please reach out to us for more information on your state.

Does each pharmacy location need its own CPA?

Yes. Each individual pharmacy location must have its own active CPA, even if under the same ownership. 

What happens if my state is not currently covered?

Outcomes expands into new states based on demand. You can contact Outcomes Customer Support to express interest to be added to a notification list for future availability.

Can B12 or testosterone injections be added to the Vaccine CPA?

No. The Vaccine CPA only supports vaccines and immunizations that are authorized under state law. B12 injections, testosterone, and other non-vaccine therapies are not included. These therapies fall outside the scope of immunizations and are considered separate clinical services.

Travel Vaccine FAQs:

Are travel vaccines included in the CPA?

Outcomes is discontinuing support for travel vaccines (e.g., typhoid, Japanese encephalitis, tick-borne encephalitis).

Why are travel vaccines being removed?

This decision was made due to increased costs associated with physician relationships and low utilization across pharmacies. This allows Outcomes to keep CPA costs low for customers.

When will travel vaccines be removed?

Travel vaccines will be removed at the time of your CPA renewal in 2026 and 2027. Pharmacies may see these changes reflected as their CPA is updated during their renewal cycle.

Yes. The CPA typically has an expiration date of one year from the physician’s signature date. In some states (e.g., GA, RI, and WA), the CPA may be valid for up to two years based on state-specific requirements.

However, Outcomes maintains annual physician relationships for all CPAs, regardless of state duration. This means that:

• All enrolled pharmacies will receive an updated CPA agreement on an annual basis
• Pharmacists are asked to sign the updated document each year to maintain active participation

Please note:

• Outcomes facilitates the annual renewal process and provides updated agreements
• Filing requirements (if applicable) are the responsibility of the pharmacy, and execution is at the pharmacy’s discretion

What is the CPA renewal process?

CPAs are renewed prior to their expiration date. As an active client, you will receive the updated CPA via email. Pharmacists must electronically sign the updated document and from there can download and store a copy at the pharmacy.

When are CPAs renewed?

CPAs are renewed throughout the year, not on a single annual date. Each CPA is tied to a state-level physician agreement. Renewal timing depends on when that CPA was originally executed. Please refer to your existing CPA or contact Outcomes Customer Support if you have questions regarding your renewal timing.

What happens if I enroll in a CPA mid-year?

If you enroll mid-year, you will receive the current active CPA so you can begin services immediately. Example: You enroll in January and your CPA originally expires in May. You sign the current CPA in January, and you will receive a renewal CPA in May. After the first cycle you will follow a standard annual renewal cadence.

CPA Filing FAQs:

Does Outcomes help with filing the CPA with my state?

No. Outcomes does not file CPAs on your behalf or provide state-specific filing guidance. This is because requirements vary by state and states use different systems and processes.

Who should I contact with CPA filing questions?

You should contact:

• Your State Board of Pharmacy
• Your State Medical Board (if applicable)
• Other governing bodies required by your state

Does Outcomes report vaccinations to the CPA physician?

No. If state law requires reporting to the CPA physician, the pharmacy is responsible for completing that reporting.

Does Outcomes support IIS reporting?

Yes. IIS reporting is available through the Outcomes Vaccine Module.

• Pharmacies can subscribe to IIS reporting services.
• In participating states, the Vaccine CPA is included at no additional charge with the Vaccine Module.

CPA Billing FAQs:

Can I bill for vaccines administered under the CPA?

Yes. Vaccines administered under the CPA can be billed as usual using your pharmacy management system (PMS).

• The CPA physician is typically used as the authorizing provider on the prescription
• Billing is submitted using your standard pharmacy or medical billing workflows

State-Specific FAQs:

Are there special requirements in Georgia?

Yes. CPAs must be filed within 30 days of physician signature. Failure to file may require a new physician signature or potential additional fees. Additionally, Georgia limits the number of pharmacies per CPA. To manage this, Outcomes offers multiple CPAs in Georgia to ensure compliance.

I’m in Georgia. Who files the CPA?

The pharmacy is responsible for filing the CPA. The physician does not file on your behalf and Outcomes does not file on your behalf. As of December 2025. Georgia implemented a new online filing portal. Pharmacies are expected to: upload the CPA with physician signature, and complete filing themselves through the new online portal.

If you receive conflicting information, please confirm with your Board of Pharmacy, as requirements may change.

Are there unique requirements in Washington?

Yes. Washington uses a Collaborative Drug Therapy Agreement (CDTA). Key differences are that Pharmacists sign first, and then the agreement is sent for physician signature.

Customization FAQs:

Can Outcomes customize the CPA to match my pharmacy’s specific workflow or requirements?

Outcomes is not able to support pharmacy-specific customization requests for the CPA. Our CPA program is designed as a state-level solution, meaning:

• Each CPA follows a standardized protocol aligned to state regulations
• The agreement is supported by a shared physician relationship that applies across multiple pharmacies in that state

Because of this structure changes cannot be made for individual pharmacies. Any updates to the CPA would impact all pharmacies enrolled under that state’s agreement.

What if my pharmacy has specific clinical or operational requirements?

If your pharmacy has additional requirements, you may need to establish your own independent CPA outside of Outcomes. This would allow for customization based on your specific needs. The Outcomes CPA is intended to provide a ready-to-use, compliant solution that works broadly across pharmacies, rather than tailored configurations.

Can I request changes to be considered in the future?

Yes. While we cannot accommodate individual changes, we do review broader feedback and trends across customers. Requests that have state-wide applicability may be considered for future updates.

General FAQs:

How much does the CPA cost?

Pricing varies depending on your service package.

• The CPA is included at no cost for Outcomes Premium Vaccine Module users
• Other pharmacies should contact Outcomes Customer Support or their sales representative for pricing

Who should I contact if I have questions?

Please contact Outcomes Customer Support for:

• CPA eligibility questions
• State-specific coverage
• Enrollment assistance
• Document requests