Professional fees refer to the compensation paid to service providers for their services. This typically includes payments to pharmacists for dispensing, compounding, or other specialized services. The regulations governing these fees vary significantly across Canada.
Table of Contents:
- Alberta
- British Columbia
- Manitoba
- New Brunswick
- Newfoundland
- Nova Scotia
- Ontario
- Prince Edward Island
- Quebec
- Saskatchewan
Alberta
Dispensing Fees: The standard dispensing fee for each prescription, excluding compounded prescriptions, diabetic supplies, and nutritional products, is set at $12.15. There are specific limits on these fees: up to three fees per day per patient for daily medication dispensing, and two fees per medication within a 28-day period for recurrent medication dispensing. Exceptions to these limits are provided for treatments related to opioid dependence, acute or short-term dispensing, and certain public health programs such as the Women’s Choice Program, Naloxone Program, and Alberta Public Health Activities Program.
Compounding Fees: For compounded prescriptions prepared directly in a pharmacy, the cost includes the price of the ingredients plus a 7.5% upcharge, in addition to a dispensing fee of $18.45. When compounded prescriptions are purchased from a compounding and repackaging pharmacy, the fees consist of the purchased compound price, an upcharge ranging from 7% to a maximum of $100, and a dispensing fee of $12.15.
Medication Review, Management, and Assessment Fees: Various fees are applied for medication-related services. For instance, trial prescriptions, therapeutic substitutions, refusals to fill, and administration of injected medications each incur a fee of $20. Other services such as prescription adaptations, renewals, medication-related emergencies, and the initiation of medication therapy also have fees of $20 and $25, respectively. Standard medication management assessments are charged at $60 per review annually, with follow-up assessments priced at $20 each and capped at 12 follow-ups per patient per year.
Vaccination Fees: The fees for administering certain vaccines are standardized. The influenza vaccine, pneumococcal vaccine for seniors, and the diphtheria-tetanus-acellular pertussis (DtaP) vaccine for pregnant women each incur a charge of $13.
Other Pharmaceutical Services: For services ensuring continuity of care during a declared state of emergency, a fee of $20 is applied. Additionally, comprehensive annual care plans include a fee of $100 for a medication review once per year, with follow-up assessments costing $20 each and also capped at 12 follow-ups per patient annually.
British Columbia
Dispensing Fees: The maximum dispensing fee is set at $10. This fee applies to standard prescription services, but certain other conditions may affect the total reimbursement. For instance, in the Methadone Maintenance Payment Program, pharmacies receive a dispensing fee plus an interaction fee of $7.70 per dispensation, with a maximum of one dispensing fee and one interaction fee per patient per day.
Compounding Fees: Compounding services are billed according to the type of preparation. Oral solutions and suspensions each cost $20, while capsules are priced at $0.30 per capsule. Suppositories and oral lozenges are charged $40, though this may be pro-rated during special authority adjudication. Other compounding fees include $20 for continuous ambulatory delivery device injections, sterile intravenous, intramuscular, and subcutaneous injections, and $40 for intrathecal injections. Fees for creams, ointments, and lotions vary by weight, with $15 for those less than or equal to 250 g/mL and $20 for those greater than 251 g/mL. Sterile preservative-free eye drops are priced at $30. It is important to note that no dispensing fee is applied to products reimbursed at retail cost, such as insulin and insulin pump supplies.
Medication Review, Management, and Assessment Fees: Standard medication review services are billed at $60, with a maximum of two reviews allowed annually, spaced at least six months apart. Pharmacist consultations are priced at $70, also with a maximum of two per year, and follow-up consultations cost $15, with a maximum of four per year. For recipients with at least five qualifying medications entered into PharmaNet within the last six months and a clinical need, only one fee can be claimed per service appointment. The total reimbursement for a combination of medication review services, clinical services, or vaccine administration on the same day and from the same pharmacy is capped at $78.
Vaccination Fees: Vaccination services administered by authorized pharmacists are billed at $12.10 per publicly funded vaccination provided to eligible residents of British Columbia.
Capitation: Pharmacies servicing long-term care Plan B facilities receive a capitation rate of $43.75 per bed serviced per month.
Other Pharmaceutical Services: Several additional services have specific fees. The Rural Incentive Program provides a subsidy ranging from $3.00 to $10.50 per claim for rural pharmacies under certain conditions. Smoking cessation services are reimbursed at $10 per dispensing of nicotine replacement therapy, with a maximum of three claims annually. Transitional coverage requests incur an additional $10 charge on top of the drug cost and dispensing fee, up to the PharmaCare maximum. For special services, such as refusal to fill a prescription, a fee of up to $20 is applied, which can be up to twice the maximum dispensing fee.
Manitoba
Dispensing Fees: The dispensing fee in Manitoba is set at a maximum of $30 per prescription. This fee applies irrespective of the base cost of the drug or its packaging. However, for prescriptions under the Employment and Income Assistance Program, the maximum dispensing fee is $6.95.
Compounding Fees: Compounding services in a pharmacy are reimbursed up to $30. If drugs require compounding under sterile conditions, pharmacies may charge up to $60. For a compounded drug to be eligible for Pharmacare benefits, its main ingredient must be a recognized Pharmacare benefit.
Medication Review: Pharmacists who have completed an approved training program are authorised to prescribe medication for the treatment of uncomplicated cystitis. The fee for this service is set at $20. Details regarding fees for broader medication review services are not specified but may be governed by additional local or provincial regulations.
Vaccination Fees: The fee for immunizations administered by pharmacists is $7, excluding COVID-19 vaccinations.
Other Pharmaceutical Services: The regulation of other pharmaceutical services is not specified in the provided information, but may include additional fees for specific programs or services that are determined by local guidelines or agreements.
New Brunswick
Dispensing Fees: The dispensing fee varies based on the type of drug and its purpose. For drugs used in the treatment of opioid dependence, such as methadone and buprenorphine/naloxone, the fee is up to $9.50. Drugs listed on the manufacturer’s price list and those on the maximum allowable price list have a dispensing fee cap of $11.00. For extemporaneous preparations, or compounded drugs, the maximum fee is set at $16.50. Methadone prescribed for chronic pain is reimbursed at up to $11.
Prescribing Fees: Prescription renewal services are available at a fee of up to $20, with a maximum of four renewal services per individual per year.
Compounding Fees: Compounding services, specifically extemporaneous preparations, are reimbursed up to $16.50. This fee applies to the preparation of custom medications not available in standard forms.
Medication Review, Management, and Assessment Fees: A medication checkup review is provided at a fee of $52.50 per beneficiary who is taking three or more chronic prescription medications, with a limit of one review per year.
Vaccination Fees: The fee for administering vaccines is $13 per injection. This includes the seasonal influenza vaccine, COVID-19 vaccine, and hepatitis A vaccine.
Other Pharmaceutical Services: For specific assessments and prescribing services, the fees are structured as follows:
- Assessment and prescribing for contraception management are reimbursed up to $20, with a limit of three assessments per individual per year.
- Assessment and prescribing for shingles (herpes zoster) are also reimbursed up to $20, with a limit of one assessment per individual per year.
- Assessment and prescribing for uncomplicated urinary tract infections (UTIs) are reimbursed up to $20, with a limit of two assessments per individual per year.
Newfoundland and Labrador
Dispensing Fees: For the 65Plus Plan, the professional dispensing fee is $12 for drug costs between $0 and $249.99, and $40 for drug costs of $250 and above. For the Foundation Plan, Access Plan, and Assurance Plan, the professional fee is $11.96 for drug costs between $0 and $49.99, $23.93 for drug costs between $50 and $249.99, and $50 for drug costs of $250 and above.
Compounding Fees: The fee for extemporaneous preparations is 1.5 times the base professional fee. For the 65Plus Plan, this equates to $12, and for all other plans, it is $11.96. Additionally, a fee of $0.10 per powder paper is provided when compounded by the pharmacist. This applies to compounds containing three or more ingredients.
Medication Review, Management, and Assessment Fees: Medication reviews are reimbursed at $52.50 per review, with a maximum of 72 reviews per year per pharmacy for beneficiaries with chronic illnesses taking three or more medications. Under the SaferMedsNL program, an initial consultation is priced at $23, with follow-up consultations at $10 each, applicable for claims over a three-year period focusing on specific drug classes such as proton pump inhibitors and sedative hypnotics. Medication management adaptations are reimbursed up to $12 per adaptation.
Vaccination Fees: The fee for administering vaccines is set at $13 per service. This fee encompasses various vaccinations as part of the routine immunisation services provided by pharmacists.
Other Pharmaceutical Services: For specific services, such as administering Mifegymiso, the fee is $50 per service. When a pharmacist refuses to fill a prescription, a fee of up to $24 may be charged. For prescribing services related to minor ailments, the fee is up to $12.
Nova Scotia
Dispensing Fees: The dispensing fee for all prescriptions, including methadone, is set at $12.25 per service. This fee applies to prescriptions for drugs or supplies, excluding ostomy supplies and compounding products.
Compounding Fees: The fee for compounded extemporaneous products, excluding methadone and injectables, is $18.37 per service.
Medication Review, Management, and Assessment Fees: The advanced medication review (AMR) is reimbursed with a maximum special services fee of $150, with a limit of one AMR per benefit year. The basic medication review (BMR) has a maximum special services fee of $52.50, also with a limit of one BMR per benefit year. Follow-up medication reviews are capped at $20 per service.
Vaccination Fees: The administration fee for seasonal influenza immunizations is $12.70 per vaccine.
Pharmaceutical Services Fees: The fees for various pharmaceutical services include $20 per service for assessment and prescribing for Lyme disease chemoprophylaxis, herpes zoster, and urinary tract infections, with limits on the number of services per year. For contraception management, the fee is $20 for the initial assessment, $20 for subsequent assessments resulting in a change in therapy, and $12 for subsequent assessments not resulting in a change, with one service of each type allowed per year. Ostomy supplies are billed at $12.25 per service.
Prescribing Fees: Prescription adaptation is covered up to a maximum of $14. Prescription renewal fees are set at $12 for three or fewer prescriptions renewed, with a limit of four services per year, and $20 for four or more prescriptions renewed, also limited to four services per year. Therapeutic substitution is reimbursed up to $26.25 per service.
Ontario
Dispensing Fees: In Ontario, dispensing fees vary between $8.83 and $13.25, depending on the pharmacy’s location. Pharmacies in rural areas receive the higher end of this range, reflecting the additional costs associated with serving less densely populated areas.
Medication Review, Management, and Assessment Fees: For MedsCheck services, the fees are as follows: $60 for a standard MedsCheck, $25 for each follow-up, $75 for a MedsCheck focused on diabetes, and $25 for each follow-up. MedsCheck at Home is reimbursed at $150 per service. Additionally, MedsCheck services for long-term care home residents are integrated into the long-term care capitation funding model, which covers these assessments as part of broader care funding.
Pharmaceutical Services Fees: The Pharmaceutical Opinion Program offers a fee of $15 per intervention when a pharmacist collaborates with a prescriber for Ontario Drug Benefit recipients. This program supports pharmacist involvement in therapeutic decisions and consultations.
Pharmacy Smoking Cessation Program Fees: For smoking cessation services, the fees are structured as follows: $40 for the first consultation (one per year), $15 for each of up to three primary follow-up counselling sessions (totaling $45), and $10 for each of up to four secondary follow-up counselling sessions (totaling $40). The annual maximum reimbursement for smoking cessation services is $125, and this program is available only to Ontario Drug Benefit recipients.
Vaccination Fees: The fee for administering an influenza immunization is $7.50 per service. This covers the cost of providing the seasonal flu vaccine to eligible individuals.
Prince Edward Island
Dispensing Fees: The dispensing fee for prescriptions in Prince Edward Island is up to $12.36. This standard fee applies to all prescriptions, with no additional charges based on the cost or type of medication.
Compounding Fees: The fee for compounded prescriptions in Prince Edward Island can be up to $18.54. This fee applies to the preparation of compounded medications as per the specific requirements of each prescription.
Medication Review, Management, and Assessment Fees: Basic medication reviews are reimbursed at $52.50, with a limit of one review per patient every 365 days. Follow-up reviews for basic medication assessments are available at $20 each, with a maximum of four follow-up reviews per year. For diabetes medication reviews, the fee is $65, also limited to one review per year. Follow-up reviews for diabetes medication management are priced at $25 each, with a maximum of four follow-ups annually.
Pharmaceutical Services Fees: Compliance packaging is charged at $25 for each 28-day supply. Refusal to fill a prescription incurs a fee of 1.2 times the standard dispensing fee. This fee structure applies to specific situations where prescriptions are not dispensed as prescribed.
Prescribing Fees: Prescription adaptation and therapeutic substitution both incur a fee of 1.2 times the dispensing fee. These fees are applied when a pharmacist makes necessary adjustments or substitutions to a prescription.
Vaccination Fees: The immunization fee for administering vaccines in Prince Edward Island is $12.36 per service. This fee covers the cost of providing various vaccines, including those required for public health initiatives.
Quebec
Dispensing Fees: The standard dispensing fee in Quebec is $10.03 per prescription. This fee applies uniformly across all types of prescriptions, excluding compounded prescriptions and certain specialized services.
Compounding Fees: In Quebec, the fees for non-sterile masterful preparations vary based on the complexity of the compounding process. There are three distinct pricing tiers, reflecting the different levels of difficulty and resource requirements involved in these preparations.
Medication Review, Management, and Assessment Fees: Several medication management services are available with specific fees. For adjustment management services aimed at achieving therapeutic targets for anticoagulation therapy, the fee is $17.18 per month. For insulin-dependent diabetes, the annual fee is $53.68. For prophylactic treatment adjustments, the fee is $42.95 per month. These fees are designed to support targeted and ongoing management of chronic conditions.
Prescribing Fees: The fee for prescribing a drug or initiating a drug therapy in Quebec is $17.18. This fee supports the professional services involved in evaluating and commencing new medication therapies.
Vaccination Fees: For vaccines administered under the Quebec Immunization Program, the fee is $11.60 when performed by a pharmacist and $9.56 when administered by a nurse. These fees cover the cost of providing vaccinations as part of public health initiatives.
Pharmaceutical Services Fees: Various pharmaceutical services are reimbursed at different rates. The fee for assessing and extending a prescription is $13.42. Management services following hospitalization are reimbursed at $26.42 per service. Medication administration in emergency situations or for demonstration purposes is compensated at $19.34. The modification of drug therapy incurs a fee of $21.25, while opioid substitution therapy is reimbursed at $15.30. For pharmaceutical consultations within the universal access program for drug-induced abortion, the fee is $19.65. Refusal to fill or refill a prescription is compensated at $9.62. Additional services include requests for consultations at $42.50, weekly support for palliative care clients at $31.71, and teaching naloxone use at $19.34. Therapeutic drug substitution is reimbursed at $17.18, and the transmission of a profile incurs a fee of $9.62.
Saskatchewan
Dispensing Fees: The maximum dispensing fee in Saskatchewan is set at $11.85 per prescription. This standard fee covers the cost of dispensing medications and applies uniformly across all types of prescriptions.
Compounding Fees: In Saskatchewan, the fee for extemporaneous compounding is $0.75 per minute, with a maximum time allowance of 60 minutes for each preparation. For most methadone compounds, the maximum time allowed is 20 minutes.
Medication Review, Management, and Assessment Fees: The Medication Assessment and Compliance Packaging Program provides an annual fee of $60 per person. Additionally, the Saskatchewan Medication Assessment Program allows for one annual medication assessment fee up to $60, with up to two follow-up assessments at $20 each, capped at $40 per year per person. These fees support comprehensive medication management and patient care.
Vaccination Fees: For influenza immunizations, the fee is $14 per service. The administration of injections for approved medications is reimbursed at $13 per injection, with a maximum of five fees allowed per year. These fees cover the cost of administering vaccines and injections, contributing to public health efforts.
Other Pharmaceutical Services: Compliance packaging services are reimbursed at $6.25 per 7-day supply, with $25 for a 28-day supply and $31.25 for a 35-day supply. This service is limited to eligible recipients of the Medication Assessment and Compliance Packaging Program. For direct observed therapy and methadone- and Suboxone-managed care, the fee is $3.50 per day or $24.50 per week. Refusal to dispense certain drugs is compensated at 1.5 times the usual dispensing fee, up to $17.78 per claim. The seamless care fee for medication reconciliation during patient transfers is similarly set at 1.5 times the dispensing fee, capped at $17.78. Smoking cessation services are reimbursed at various levels, with a maximum of $180 per person per year for comprehensive support, including follow-ups and group sessions. For trial prescriptions, a fee of $7.50 is provided for a follow-up, with subsequent refills subject to usual reimbursement rates.
The above summary of pharmacy professional fees is based upon information from the Canadian Institute for Health Information as last updated on March 31, 2024.