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North Carolina: e-Prescribing of Controlled Substances

The Practice Fusion EHR provides advanced electronic prescribing capabilities, including electronic prescribing of controlled substances (EPCS*).

Practice Fusion: Using an EHR system to meet North Carolina state mandates for certified EPCS. EPCS allows you to:

  • e-Prescribe scheduled drugs right from the Practice Fusion EHR
  • Use one workflow for all prescriptions
  • Minimize patient wait times at pharmacies
  • Reduce unnecessary office visits
  • Improve safety and reduce fraud and abuse
  • Integrate with your state’s Prescription Drug Monitoring Program (PDMP) to check for patients with duplicate prescriptions or other signs of “doctor shopping”
  • Fully integrate with the Practice Fusion EHR and e-prescribing workflow
  • Use a streamlined process for fast identity verification
  • Automatically check patient-specific formularies and perform drug and allergy checks
  • Automatically receive Electronic Prior Authorizations (ePA) for prescriptions

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North Carolina State Mandates

Electronic Prescribing of Controlled Substances (EPCS)

Federal Mandate: Medicare Advantage & Medicare Part D Practitioners In 2018, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act was passed by the federal government.1,2 This Act includes legislation that requires Medicare Advantage and Medicare Part D practitioners to begin electronically prescribing controlled substances January 1, 2021. Medicare Advantage and Medicare Part D prescribers in every state are subject to the above mandate and must comply. Due to the COVID-19 health emergency, the Centers for Medicare & Medicaid Services (CMS) has postponed penalties for noncompliance; however, enforcement of those penalties will begin January 1, 2022.2,3

North Carolina State Mandate: All Prescribers Beginning in 2017, the state of North Carolina requires all prescribers to e-prescribe targeted schedule II and III controlled substances.4 Medicare Advantage and Medicare Part D prescribers in North Carolina are additionally subject to the federal mandate, which requires e-prescribing of schedule II, III, IV, and V controlled substances.5 Prescribers subject to the federal mandate may choose to e-prescribe controlled substances for all patients, regardless of payer. Prescribers not subject to the federal mandate may also choose to e-prescribe controlled substances. Doing so may reduce burden, improve workflow productivity, and increase safety and security.

Practice Fusion will continue to monitor legislative changes in the state of North Carolina and will alert providers of any upcoming regulatory changes or requirements.

Prescription Drug Monitoring Program (PDMP), or North Carolina Controlled Substances Reporting System (CSRS)

Prescriber review of the PDMP—also known as the North Carolina Controlled Substances Reporting System (CSRS)—became mandatory in 2021. Prescribers are required to query the NC CSRS before writing a prescription for any schedule II or III controlled substance to check the patient’s twelve-month prescription history. Prescribers should also query the CSRS and review a patient’s information every three months that the substance remains part of his or her treatment or any time the medication or dosage changes. Opioid treatment programs are required to check the CSRS at least monthly for each patient.4,6-9

Why choose Practice Fusion in North Carolina for EPCS

Whether you just need a simple solution to address state mandates or are interested in more robust features such as text message appointment reminders or charting, Practice Fusion has the right features to meet your needs. We offer advanced e-prescribing capabilities including EPCS, prior authorization management, and allergy alerts. Your subscription will also include features such as:

  • Charting
  • Electronic lab and imaging test ordering and results
  • Compliance tracking
  • Appointment scheduling
  • Text message appointment reminders
  • Support for quality payment programs

In addition, Practice Fusion is able to integrate directly with North Carolina’s PDMP database, or CSRS. This means prescribers can consult CSRS from within their existing workflow.

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  1. Centers for Medicare & Medicaid Services (CMS). Medicare Program: Electronic Prescribing of Controlled Substances; Request for Information (RFI). Federal Register: The Daily Journal of the United States Government. Updated August 4, 2020. Accessed September 16, 2021,
  2. CMS delays enforcement of e-prescribing requirement for controlled substances. California Medical Association. Updated December 15, 2020. Accessed September 16, 2021,
  3. CMS formally delays EPCS enforcement. National Community Pharmacists Association. Updated December 4, 2020. Accessed August 22, 2021,
  4. State PDMP Profiles and Contacts. Prescription Drug Monitoring Program Training and Technical Assistance Center. Updated July 7, 2021. Accessed August 19, 2021,
  5. Public Law No: 115-271 (10/24/2018) H.R.6 - SUPPORT for Patients and Communities Act ( - U.S. Governnent Publishing Office).
  6. NC Controlled Substances Reporting System. North Carolina Department of Health and Human Services (NCDHHS). Accessed August 6, 2021,
  7. Resources & Information. North Carolina Medical Board. Accessed August 6, 2021,
  8. CSRS Mandatory Use and Technical Assistance. North Carolina Department of Health and Human Services (NCDHHS). Accessed August 6, 2021,
  9. Important Notice for North Carolina Prescribers: STOP Act is fully enacted. Accessed August 6, 2021.

*Electronic Prescriptions for Controlled Substances (EPCS) is only available in the 50 US states and the District of Columbia