This section covers traditional prescriptions written on paper script pads. The central requirement for this format, regardless of drug schedule, is the practitioner's original, manual signature.
Schedule II
Requirements
- Must be a written prescription.
- Must be manually signed by the practitioner.
📝MPJE Tip
Always ensure any paper prescription has a manual, "wet" signature. A signature stamp is never acceptable for any controlled substance.
Schedules III, IV, & V
Requirements
- Must be manually signed by the practitioner.
✔Best Practice
The rule is identical to Schedule II for paper scripts: a manual signature is mandatory. Do not accept stamped signatures.
This applies to prescriptions generated on a computer and then printed. It's critical to understand that these are legally considered paper prescriptions, not electronic ones, and must be handled as such.
Schedule II
Requirements
- Must be manually signed by the practitioner after printing.
- The original signed prescription is required before dispensing.
📝MPJE Tip
A computer-generated, printed prescription is legally a paper prescription. It is NOT an electronic prescription and needs a wet signature.
Schedules III, IV, & V
Requirements
- Must be manually signed by the practitioner after printing.
✔Best Practice
Same as Schedule II, these must be manually signed. The legal classification as a "paper prescription" is the key takeaway.
The rules for faxed prescriptions represent a major point of difference between drug schedules. Understanding when a fax can serve as the original prescription is essential for compliance.
Schedule II
Requirements
- Fax is for advance notice only.
- The original, manually signed paper prescription must be presented before dispensing.
⚠Exceptions
A fax can serve as the original for:
1. LTCF patients.
2. Hospice patients.
3. Compounded narcotics for direct patient administration (e.g., infusion).
Schedules III, IV, & V
Requirements
- A fax of a manually signed paper prescription is acceptable as the original.
- Can be transmitted by the practitioner or their agent.
📝MPJE Tip
DON'T dispense a routine faxed CII without the original hardcopy. DO differentiate the fax rules: for CIII-V, the fax can serve as the original.
Oral, or phoned-in, prescriptions are another area with critical differences between schedules. Routine oral prescribing is prohibited for Schedule II drugs but common for others.
Schedule II
Requirements
- Only permissible in declared emergency situations.
- Routine oral prescriptions are strictly prohibited.
Schedules III, IV, & V
Requirements
- An oral prescription from a practitioner is routinely acceptable.
- Must be promptly reduced to writing by the pharmacist.
📝MPJE Tip
Know the difference: Oral CIIs are emergency-only. Oral CIII-Vs are routinely acceptable if the pharmacist writes them down immediately.
True electronic prescriptions for controlled substances (EPCS) are allowed for all schedules but require stringent, DEA-certified software systems for both the prescriber and the pharmacy.
Schedule II
Requirements
- Permitted if the practitioner's and pharmacy's software systems meet all specific DEA security and certification requirements (Part 1311).
Schedules III, IV, & V
Requirements
- Permitted if the practitioner's and pharmacy's software systems meet all specific DEA security and certification requirements (Part 1311).
📝MPJE Tip for All Schedules
DO ensure any system used for EPCS is DEA compliant. DON'T confuse a computer-generated fax with a true, compliant electronic prescription. They are not the same.