If you are still only dispensing medication, you are fighting a losing battle against shrinking margins.

But if you look at the successful independent pharmacies in 2025, they have all made one specific pivot: they have become a destination for point-of-care testing (POCT).

Why? Because patients are tired of waiting three days for a doctor’s appointment just to find out if they have Strep. They want answers now. And with the rapid expansion of “Test and Treat” laws across the country—from Oregon to West Virginia—you are uniquely positioned to give them those answers.

Point-of-care tests are the “gateway drug” to medical billing. They are low overhead, high demand, and they train your team to think like providers, not just dispensers.

However, launching a clinical lab in a retail space isn’t as simple as buying a box of swabs. With the CMS phasing out paper CLIA certificates in 2026 and new multiplex testing codes, the landscape has changed.

Here is your national, step-by-step guide to launching a compliant, profitable POCT program this year.

Step 1: The License (The New 2026 Rules)

You cannot perform a single poct test without a CLIA Certificate of Waiver. This is your license to operate a simple, low-risk laboratory.

The Old Way: You mailed a check and waited for a paper certificate. The 2025/2026 Way: The system is going digital.

• The Deadline: Starting March 1, 2026, CMS will no longer mail paper fee coupons or certificates. Everything is moving to email notifications and online payments via Pay.gov.
• Action Item: If you are already enrolled, log in to the CMS portal now and ensure your email address is current. If you miss a renewal email because it went to an old inbox, your lab status could be revoked.
• The Cost: The waiver fee is typically around $180 every two years, a tiny investment for the return you will generate.

Step 2: Select Your Menu (Think “Multiplex”)

In 2025, efficiency is king. You don’t want to swab a patient three different times. The standard of care has shifted to multiplex testing—single swabs that test for multiple pathogens at once.

The “Must-Have” Menu for 2025:

1. COVID-19 + Flu A/B: This is now the standard for respiratory symptoms.
2. Strep A: A high-volume perennial favorite, especially for pediatric parents.
3. A1c & Lipids: Essential for chronic care management (CCM) and preventative screenings.

Pro-Tip: Don’t buy a $20,000 machine unless you have the volume to support it. Many point-of-care tests are “visually read” (like a pregnancy test) and require zero capital investment. Start small, prove the concept, then upgrade to digital readers.

Step 3: Build the “Test and Treat” Workflow

The biggest fear owners have is: “I don’t have time to do this at the counter.” You are right. You shouldn’t be doing it at the counter.

The “Parking Lot” Model: For infectious diseases (Flu/COVID/Strep), keep the patient out of the store.

1. Intake: Patient books online and fills out the consent form digitally.
2. The Swab: Pharmacist or trained technician goes to the curbside/drive-thru to collect the sample.
3. The Result: You run the test inside.
4. The Consult: You call the patient with results. If positive (and allowed by your state’s “Test and Treat” laws), you prescribe the antiviral or antibiotic and have it ready for pickup.

This workflow keeps your pharmacy safe and your dispensing queue moving.

Step 4: Billing the Medical Benefit (The Revenue Engine)

This is where most pharmacies fail. They try to bill the test to the PBM (Pharmacy Benefit Manager) and get rejected.

Point-of-care testing is a medical service. You must bill the patient’s medical insurance (Medicare Part B, BCBS, Aetna, etc.) using a CMS-1500 form.

The 2025 Cheat Sheet for Codes:

• The Test (The Product):
  • 87880 QW: Strep A (rapid)
  • 87811 QW: SARS-CoV-2 (COVID-19)
  • 83036 QW: Hemoglobin A1c
  • Note: The “QW” modifier is mandatory. It tells the payer, “This is a CLIA-waived test performed in a pharmacy.”
• The Service (Your Time):
  • This is where you make your margin. You typically bill an “Evaluation and Management” (E/M) code (like 99211 or 99212) for the assessment.
  • The “Modifier 25” Rule: If you bill for the test and the visit on the same day, you often need to attach Modifier 25 to the visit code to prove it was a “separately identifiable service”.

Step 5: Don’t Go It Alone

Launching what is point of care testing into your business model changes you from a retailer to a clinic. It opens up new liability, new revenue, and yes, new paperwork.

The clinical part is easy for you—you’re a pharmacist. The billing part is the headache.

You shouldn’t have to spend your nights fighting with insurance rejections or trying to figure out why your CLIA waiver renewal email didn’t arrive. At RxBB, we handle the credentialing, the medical billing, and the compliance monitoring for you.

You take care of the patient. We’ll make sure you get paid for the test and your time.

Actionable Checklist for Today:

1. Check your CLIA status: Log in to CMS and update your email for the 2026 digital transition.
2. Order “Multiplex” kits: Stop buying separate Flu and COVID tests.
3. Book a demo: See exactly how much POCT could add to your bottom line this flu season.