Written Protocol · PharmD
Georgia Drug Therapy Modification (DTM) Protocol for Pharmacists
Required. The Drug Therapy Modification (DTM) Protocol is the written instrument Georgia 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.
Several separate, narrower protocol-gated pathways rather than one unified 'collaborative practice' status — none amounts to general independent prescribing. No Georgia flu/strep 'test and treat' law was found (a commonly-repeated claim traces to North Carolina legislation, not Georgia — confirmed as a cross-state citation error and excluded here).
Independent practice requires: Certified for Drug Therapy Modification (O.C.G.A. §§ 26-4-50, 43-34-24) — physician must first diagnose and issue a written order/protocol; pharmacist adjusts only within that patient-specific protocol; OR certified for vaccine administration under a physician-issued protocol (§ 43-34-26.1) or, for pharmacy technicians specifically, under a supervising pharmacist for certain adult vaccines (§ 26-4-52); OR (eff. 7/1/2026) certified to prescribe/dispense PrEP/PEP under a statewide Board of Pharmacy protocol with physician oversight (S.B. 195, 2025-26 session); OR (protocol expected eff. 1/1/2027) certified to dispense hormonal contraceptives under a joint DPH/Board of Pharmacy protocol (H.B. 1138, signed 5/11/2026).
What a Georgia Drug Therapy Modification (DTM) Protocol must contain
Governed by the Georgia State Board of Pharmacy. Each numbered item is a statutory requirement the agreement must satisfy.
The Pharmacist may modify an existing drug therapy for a patient under the direct medical care of the Physician only pursuant to a written drug therapy modification ("DTM") protocol meeting the requirements of Ga. Comp. R. & Regs. r. 480-35-.04, and only if the Pharmacist holds current DTM certification issued by the Georgia State Board of Pharmacy. The Physician retains sole authority to diagnose the patient's condition and to initiate the patient's drug therapy; the protocol authorizes the Pharmacist only to modify that already-initiated therapy within the parameters, drug classes, and dosage ranges the protocol specifies.
The protocol shall identify the patients covered (with a mechanism for a patient to opt out), the Physician's diagnosis and initial drug therapy for each patient, the parameters and responsibilities for modification, the monitoring required of both the Pharmacist and the Physician, and the procedures and notification methods the Pharmacist must follow when modifying therapy. The protocol automatically terminates no later than two (2) years after its effective date unless renewed in writing, and immediately terminates if either party's license or the Pharmacist's DTM certification lapses, is revoked, or is not renewed.
- The Drug Therapy Modification (DTM) Protocol on file also carries 1 scope, 1 registration clauses, generated in the document itself.
Statutes and rules cited
- Ga. Comp. R. & Regs. r. 480-35-.04board rule
Requirements for a pharmacist drug therapy modification (DTM) protocol, including required protocol contents, physician diagnosis/initiation, monitoring, and termination.
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
As needed
Ga. Comp. R. & Regs. 480-35-.04 requires the drug-therapy-modification protocol to specify a 'method and frequency of notification to the physician' of any modification — parties define the cadence themselves; no board-mandated frequency was found.
Prescriptive authority
Separate prescribing terms required · controlled substances permitted
This cross-reference is confirmed to exist, but the full text of §§ 16-13-41/-74 was not independently read to confirm exactly how it constrains Schedule II modification in practice — flag as partially verified.
Written agreement
Required
True for Drug Therapy Modification (written protocol) and vaccine administration (protocol agreement). PrEP/PEP uses a statewide Board-developed protocol rather than a per-pharmacist agreement. Base dispensing/counseling needs no physician agreement.
Practice ownership (corporate practice of medicine)
Non-licensee ownership permitted — O.C.G.A. § 26-4-110 explicitly contemplates pharmacy ownership by 'a sole proprietor, partnership, association, corporation, or otherwise' — no requirement that the owner be a licensed pharmacist. Every pharmacy must designate a 'pharmacist in charge' with personal supervision of the prescription department during operating hours (limited exceptions for hospitals/nursing homes/pharmacy schools/HMOs); one pharmacist may supervise only one location at a time.
Materially more permissive than the physician/APRN CPOM framework above.
Legal sources for these rules (7)
- O.C.G.A. § 26-4-50 — Drug therapy modification certificationsecondary
- O.C.G.A. § 43-34-24 — Drug therapy management/modification by a pharmacist
- O.C.G.A. § 26-4-110 — Pharmacy licenses/ownershipsecondary
- Ga. Comp. R. & Regs. R. 480-35-.04 — Requirements for a Protocol (via Cornell LII mirror)secondary
- O.C.G.A. § 43-34-26.1 — Vaccine protocol agreements; § 26-4-52 — Pharmacy technician vaccine administration
- S.B. 195 (2025-26 session) — PrEP/PEP pharmacist authority, signed, eff. 7/1/2026 — SECONDARY SOURCE ONLY, bill text not independently fetched
- H.B. 1138 (2026 session) — 'Increasing Access to Contraceptives Act,' signed 5/11/2026, joint protocol expected eff. 1/1/2027 — SECONDARY SOURCE ONLY, bill text not independently fetched
About Georgia's rules
Georgia remains one of the more restrictive states in this dataset — no independent-practice pathway exists for NP/PMHNP/CRNA/CNM/CNS, and a 50-mile APRN physician-proximity rule was NOT removed by 2023-2024 reform (a common misconception). That reform raised the ratio cap (4→a combined 8 APRNs+PAs) and added a narrow hydrocodone/oxycodone-only Schedule II exception — APRNs/PAs are otherwise barred from Schedule II. Georgia's primary-source sites were unusually inaccessible this pass; treat citations with extra caution pending follow-up.
Other clinicians in Georgia: see the state overview.