Collaborative Practice Agreement · PharmD

Alabama CDTM Agreement for Pharmacists

Required. The CDTM Agreement is the written instrument Alabama law names for a Pharmacist working with a physician. Below: the board that governs it, what it must contain, and the terms it has to carry.

Practice authoritySupervision required
Written agreementAgreement required
What Alabama calls itCDTM Agreement
Governing boardAlabama State Board of Pharmacy
Agreement familyCollaborative Practice
Research date2026-09-03 · clauses 2026-09-03

Represents Alabama's Collaborative Practice tier (Ala. Admin. Code r. 680-X-2-.44, enforceable since May 1, 2022), not base dispensing licensure. Jointly approved by the Board of Pharmacy and Board of Medical Examiners; permanently agreement-dependent with no independence pathway.

What a Alabama CDTM Agreement must contain

Governed by the Alabama State Board of Pharmacy. Each numbered item is a statutory requirement the agreement must satisfy.

  1. The Pharmacist shall practice pursuant to a Collaborative Drug Therapy Management Agreement (the "CDTM Agreement") with the Physician, as authorized by Ala. Code § 34-23-77 and Ala. Admin. Code r. 680-X-2-.44. Neither the Physician nor the Pharmacist may engage in collaborative drug therapy management until the CDTM Agreement, together with a written attestation naming the parties and describing the scope of covered services, has been submitted to and approved by both the Alabama State Board of Pharmacy and the Alabama Board of Medical Examiners; submission must occur within ten (10) days after the Agreement is signed.

    Source: Ala. Code § 34-23-77

  2. Each party to the CDTM Agreement must hold an active, unrestricted Alabama license. The Physician must have practiced medicine for at least three (3) years, or at least one (1) year if board-certified by a specialty board approved by the American Board of Medical Specialties or the American Osteopathic Association Bureau of Osteopathic Specialists.

    Source: Ala. Admin. Code r. 680-X-2-.44

  3. The CDTM Agreement on file also carries 2 scope, 1 education, 1 registration, 1 authority clauses, generated in the document itself.

Statutes and rules cited

  1. Ala. Code § 34-23-77statute

    Authorizes a Collaborative Practice Agreement between an Alabama-licensed pharmacist and physician; requires the agreement to be submitted to and approved by both the Board of Pharmacy and the Board of Medical Examiners before it is effective.

  2. Ala. Admin. Code r. 680-X-2-.44board rule

    Alabama Board of Pharmacy rule implementing Collaborative Drug Therapy Management Agreements: required terms, eligibility, quality assurance, renewal, and limitations.

Terms it has to carry

Ratio, proximity, chart review, meeting and prescribing terms the agreement has to carry, from the state's supervision rules.

Proximity

Not codified — left to the agreement

Supervision ratio

Not codified — no cap on file

Chart review

Not codified — left to the agreement

Meeting cadence

Not codified — left to the agreement

Prescriptive authority

Covered by the practice agreement · controlled substances permitted

Agreement must specify duties performed, documentation/communication protocol, a quality-assurance plan, and (for drug-therapy CPAs) the authorized formulary; renewable every 2 years, amendments/termination reportable within 10 days (Ala. Admin. Code r. 680-X-2-.44).

Written agreement

Required

Practice ownership (corporate practice of medicine)

Non-licensee ownership permitted — General Alabama pharmacy-ownership rules (Board of Pharmacy permit/pharmacist-in-charge requirements) apply; no 'friendly PC' style restriction unique to collaborative-practice pharmacists distinct from standard pharmacy ownership rules was found in this research pass.

Materially more permissive than the healing-arts/APRN PC ownership regime governing PA/CRNP/CNM/CNS above.

Legal sources for these rules (1)
  • Ala. Admin. Code r. 680-X-2-.44 — Collaborative Pharmacy Practice
How the relationship works day to day
Who has to be where, how often you meet, and what the physician costs: Pharmacist in Alabama on collaborativeagreement.com.

About Alabama's rules

Alabama is a restrictive state: PA/CRNP/CNM all require an indefinite collaborative agreement with no independence pathway, and share a combined 360 hours/week (9 FTE) supervision cap per physician. CRNA's status is a genuine ambiguity — statute requires an 'immediately available' physician/dentist/podiatrist, but no filed agreement or ratio regime exists like CRNP/CNM's; flagged for legal review.

Other clinicians in Alabama: see the state overview.