Pharmacists ordering lab tests
Last updated on September 19, 2024This web page introduces legislation and regulations; standards, limits and conditions; and the tests pharmacists can order.
For requirements before a pharmacist can refer for lab testing, please visit Requirements for laboratory referrals. Pharmacists wanting to refer for testing should thoroughly review and follow the instructions.
On this page: Legislation | Tests pharmacists can order | CPBC standards, limits and conditions | Instructions
Effective August 30, 2024, pharmacists are designated as “referring practitioners” in the Laboratory Services Regulation (LSR), under the Laboratory Services Act (LSA). The designation allows them to order certain laboratory tests, as benefits, for the purpose of medication management. The change equips pharmacists with more clinical tools to deliver medication management services.
Relevant legislation and regulation
Enacted on October 1, 2015, the LSA consolidated of publicly-funded laboratory services under a single legislative framework and identifies the Minister of Health as responsible for the administration and provision of laboratory services in B.C. Under the LSA, the Minister of Health can determine which laboratory services are benefits (i.e., publicly funded) and which laboratory services can be requested by a referring practitioner or class of referring practitioners.
The LSR establishes certain healthcare practitioners as referring practitioners, who may independently refer B.C. Medical Services Plan (MSP) beneficiaries for laboratory tests in accordance with their respective referring practitioner schedule. The tests must be medically required and provided at an approved laboratory facility by or under the supervision of a laboratory medicine physician.
Effective August 30, 2024, under the LSR, pharmacists are prescribed as referring practitioners and are authorized to refer MSP beneficiaries for laboratory testing. The scope of tests are limited to certain services related to “practice of pharmacy” defined in the Pharmacists Regulation, as follows:
- Identifying and assessing drug-related and device-related problems and taking action to prevent or resolve those problems
- Monitoring drug therapy and advising on therapeutic values, contents and hazards of drugs and devices
Pharmacists, as referring practitioners under the LSA, must consider all relevant Ministry of Health guidelines and protocols when requesting a benefit. This includes the BC Guidelines.
Under the LSA, referring practitioners must not charge a beneficiary for any matter that relates to the provision of a benefit, including consultations.
PharmaCare policies
No specific fees will be available to pharmacists for ordering laboratory tests. The new authority is intended to enhance pharmacists’ ability to perform comprehensive patient assessments for drug therapy management. Pharmacists may continue to submit claims for clinical services fees or medication reviews in accordance with the PharmaCare Policy Manual.
Tests that pharmacists can order
Pharmacists may order outpatient fee-for-service (FFS) tests listed in Schedule H-Pharmacists Laboratory Services Referral Schedule, which can be found on the practitioner schedules on the Provincial Laboratory Medicine Services (PLMS) web page.
Non-fee-for-service (non-FFS) tests that are funded through a health authority’s global operating budget and considered as benefits under the LSA can be ordered by pharmacists, provided the testing falls within their scope of practice. These tests will most often be ordered in inpatient or specialized settings, and generally will not apply in the typical out-patient setting. There is no separate comprehensive list of non-FFS tests that pharmacists can order.
CPBC standards, limits and conditions
When a pharmacist refers a patient for laboratory testing, they must do so in accordance with the College of Pharmacists of BC's standards, limits and conditions for ordering, receiving and interpreting laboratory tests. These standards, limits and conditions outline competency, assessment, follow-up, documentation and notification requirements.
Instructions and training
Training information, procedures and other information relevant to pharmacist ordering of laboratory tests will be added to this page as it becomes available. Watch this page and subscribe to the PharmaCare Newsletter.
UBC Continuing Pharmacy Professional Development (CPPD) will offer optional accredited clinical education on interpreting laboratory test results and laboratory stewardship principles beginning in January 2025. The education will be offered to pharmacists in B.C. at no cost. Registration details will be posted as courses become available. Participation is highly recommended.
Under the new authorization, pharmacists will use their professional discretion to determine if a lab test referral is necessary to manage medications. They are not expected to order lab tests for minor ailments and contraception (i.e. MACS) as those conditions can be readily diagnosed without the need for laboratory or imaging tests.
To learn about the processes required before a pharmacist can refer for laboratory testing, including how to obtain an unique Medical Services Plan (MSP) practitioner number, please visit Requirements for laboratory referrals.
More information
For any questions about pharmacist lab ordering, please email PCI@gov.bc.ca