Claims must be submitted in the manage your service (MYS) portal by the fifth of the month for:
- PFS payment
- NHS Minor Illness referrals
- Urgent Medicine Supply
- Reimbursement of costs for items supplied for the Urgent Medicine Supply
Later submissions will only be accepted if they’re made by the final day of the month following the month in which the consultation was conducted.
Claims for consultations carried out in March, April, and May 2025 must be claimed by 11:59pm on 30 June 2025.
Later claims will not be paid unless the submission was delayed by IT issues outside of your control.
These claims can be accepted within 12 months of when the claim should have been submitted, providing you send evidence of the IT issue to the NHS Business Services Authority (NHSBSA).
EPS tokens for exempt patients must still be sent to the NHSBSA to be scanned and kept for Post Payment Verification (PPV) purposes.
PFS tokens must be clearly separated within the batch and marked ‘PF CP’.
UMS tokens must be clearly separated within the batch and marked ‘PF UMS’.
Clinical pathway consultations must be completed in accordance with PGD guidelines. If a claim is received and is found not to be within the PGD guidelines or service specification, the NHSBSA can withhold payment until evidence is provided that it was supplied correctly.
Further information about claiming for the PFS can be found in Part VIC of the Drug Tariff.
Consultation fees and monthly fixed payment
You’ll be paid £17 per completed consultation.
From June 2025, all contractors must have signed up to deliver the contraceptive service and must be registered and able to deliver the Hypertension Case-finding Service to receive the fixed monthly payment.
Contactors delivering between 20 to 29 consultations per month will receive a fixed payment of £500.
Contractors delivering a minimum of 30 consultations per month will receive a fixed payment of £1,000.
| Month | Minimum number of consultations required to be delivered during the month to secure the £500 fixed payment | Minimum number of consultations required to be delivered during the month to secure the £1,000 fixed payment |
|---|---|---|
| February 2024 | Not applicable until June 2025 | 1 |
| March 2024 | Not applicable until June 2025 | 5 |
| April 2024 | Not applicable until June 2025 | 5 |
| May 2024 | Not applicable until June 2025 | 10 |
| June 2024 | Not applicable until June 2025 | 10 |
| July 2024 | Not applicable until June 2025 | 10 |
| August 2024 | Not applicable until June 2025 | 15 |
| September 2024 | Not applicable until June 2025 | 20 |
| October 2024 | Not applicable until June 2025 | 20 |
| November 2024 | Not applicable until June 2025 | 20 |
| December 2024 | Not applicable until June 2025 | 20 |
| January 2025 | Not applicable until June 2025 | 25 |
| February 2025 | Not applicable until June 2025 | 25 |
| From March 2025 | Not applicable until June 2025 | 30 |
| From June 2025 | 20 to 29 | 30 |
From October 2024, the methodology used to set the quarterly caps for Pharmacy Clinical Pathways changed to remove the cap of 3,000 consultations per month.
From April 2025, the methodology to set the monthly caps changed.
The average monthly delivery of consultations is worked out using 3 months of the most recent data available.
Contractors are placed in ‘bands’ from this average and will be capped to a specific number of consultations.
The top band cannot exceed more than 700 consultations each month.
The lowest band has a cap of 30 consultations each month meaning they're still able to meet the criteria to get the monthly fixed payment of £1,000.
Contractors can conduct more consultations than their cap allows, but they’ll not be paid the £17 fee for the consultations above the cap.
| Band | Average Pharmacy First Clinical Pathway consultations delivered per month from January 2025 to March 2025 | Maximum number of Pharmacy First Clinical Pathway consultations per month for which payment will be received |
|---|---|---|
| Band 1 | Less than 16 | 32 |
| Band 2 | 16 to 22 | 42 |
| Band 3 | 23 to 27 | 56 |
| Band 4 | 28 to 30 | 63 |
| Band 5 | 31 to 38 | 74 |
| Band 6 | 39+ | 131 |
The cap allocation for each pharmacy can be found on our website. You can check which band and cap your pharmacy has.
Read more information about PFS payments in Part VIC of the Drug Tariff.
Opting out of PFS
If you want to stop providing PFS, you must de-register on MYS and provide 30 days’ notice. You must still provide PFS within the 30 days and will be paid as usual.
You will not be able to re-register for 4 months from the final day of your 30 day notice period, after this you can re-register on MYS.