Minor Ailments and Contraception Service (MACS)

Last updated: September 7, 2023

As of June 1, 2023, B.C. residents can seek treatment for 21 minor ailments and contraception directly from a pharmacist.

PharmaCare compensates pharmacies for providing this service. Pharmacies can claim the $20 MACS fee for assessing eligible B.C. residents for any of the MACS ailments and contraception, whether or not the assessment leads to a prescription.

This page is for pharmacists. Information for the public is available at www.gov.bc.ca/SeeAPharmacist

Refer to the College of Pharmacists of BC for details about clinical and practice requirements.

PharmaCare will regularly share monitoring and evaluation data on the expanded pharmacy services, including usage, participation and changes over time. Click the links below for the latest data.

Pharmacist requirements and procedures

Pharmacists must complete the PPMAC Regulatory Education module to provide MACS. To claim the MACS fee, they must comply with the standards, limits and conditions set out in the BC Health Professions Act Bylaws Schedule F, Part 8 – Pharmacist Diagnosing and Prescribing, and with the requirements of Section 8.14 of the PharmaCare Policy Manual.

To claim the MACS fee, a pharmacist must also:

  • Carry out MACS with the patient (or their legal representative) in person—not by telephone or other electronic means
  • Provide MACS in a suitable area that the patient accepts as respectful of their right to privacy and that meets their requirements for cultural safety
  • Document MACS in accordance with the requirements of Section 8.14 of the PharmaCare Policy Manual, including using the MACS Form (PDF) or their own form that captures the same information.

Pharmacists prescribing in HAs and PCNs

Pharmacists in health authorities and primary care networks can leverage their expertise to prescribe.

Pharmacists that receive a prescription from another pharmacist should fill the prescription as usual and enter in the prescribing pharmacist's name as the prescriber. They cannot claim a MACS assessment fee.

Example: Pharmacist Sally works in a primary care network. She sees a patient for a medication management consult and, as part of the assessment, prescribes an NSAID to manage musculoskeletal pain. The patient takes the prescription to her community pharmacy of choice. The community pharmacist Theo then fills the prescription as usual, with Sally as the prescriber. Theo does not submit a claim for a MACS assessment.

MACS and Plan W clients

Pharmacists are reminded that Plan W covers a variety of over-the-counter (OTC) items that can be recommended as part of MACS or during a regular pharmacy visit. If a pharmacist recommends a Plan W OTC item as part of a MACS assessment, they should:

  • Document the recommended item on the MACS form only
  • Submit the claim for the OTC in PharmaNet to have it covered under Plan W

If Plan W OTC items are recommended outside of MACS, pharmacists must use the Plan W OTC Recommendation form and enter the medication in PharmaNet.

Ensuring Plan W coverage of OTC medications for FNHA clients is a component of culturally safe pharmacy practice.

View the full list of First Nations Health Benefits (Plan W): Over-the-counter drugs

Steps for pharmacists

  1. Inform the patient of the service, confirm the patient's coverage and clinical eligibility, and obtain consent.
  2. Review the patient's PharmaNet profile.
  3. Determine the nature of the patient’s symptoms, and assess their medical and medication history.
  4. Recommend appropriate treatment, which may include medication, self-care advice, and/or advice to see other health care professionals.
  5. Provide advice about taking the prescribed or recommended medication, advise them of any potential side effects or interactions, and ensure they know what to do if symptoms do not improve.
  6. Establish, implement, document and inform the patient of their follow-up and monitoring plan.

Note that PharmaCare will not reimburse a medication review service claim and a MACS claim for the same patient from the same day. Details are in Section 8.14 of the PharmaCare Policy Manual.

Submitting a claim

A MACS claim must be entered in PharmaNet on the same day the service is provided. The corresponding PIN and College Registration Identification (Reg ID) of the pharmacist who provided MACS must be included.

Each ailment has 4 PINs to cover the possible outcomes of a MACS assessment. PINs and their descriptions are available on the PINs web page and in the MACS conditions, PINs and drugs reference guide (PDF). The pharmacist must enter the 10-digit pharmacy phone number at the start of the SIG field.

PINs are also required when providing MACS to ineligible patients or virtually. For non-benefit MACS, the pharmacist must enter the minor ailment assessed, at the start of the SIG field, in addition to the phone number .

Special Authority (SA) requests

MACS expands the opportunities for pharmacists to submit SA requests (e.g., through eForms). Pharmacists may request SA coverage for a patient when:

  • Prescribing for minor ailments or contraception (new!)
  • Recommending OTC medications, such as acetaminophen or NRTs
  • Adapting a prescription
  • Applying for exceptional Plan Z coverage
  • Dispensing vancomycin following a hospital stay, or
  • Working in a clinical setting in collaboration with a prescriber and with access to the patient’s full medical record (accessing only PharmaNet is insufficient)

List of minor ailments

MACS ailments and drugs
Minor ailment Drugs a pharmacist can prescribe 
acne topical drugs
allergic rhinitis intranasal drugs (including antihistamines), ophthalmic drugs (including antihistamines), oral antihistamines
conjunctivitis (allergic, bacterial or viral) ophthalmic drugs
dermatitis (allergic, atopic, contact, diaper or seborrheic) topical drugs
dysmenorrhea non-steroidal anti-inflammatory drugs (NSAIDs)
dyspepsia gastric acid-reducing drugs
fungal infections (onychomycosis, tinea corporis infection, tinea cruris infection or tinea pedis infection) topical drugs
gastroesophageal reflux disease gastric acid-reducing drugs
headache NSAIDs
hemorrhoids topical drugs
herpes labialis topical drugs (including antiviral), other types of antiviral drugs
impetigo topical drugs
musculoskeletal pain NSAIDs
nicotine dependence nicotine cessation drugs
oral ulcers (canker sores, aphthous ulcers) topical drugs
oropharyngeal candidiasis antifungal drugs
shingles antiviral drugs
threadworms and pinworms anthelmintic drugs
urinary tract infection (uncomplicated) antibiotic drugs
urticaria, including insect bites topical drugs (including antihistamines), other antihistamine drugs
vaginal candidiasis antifungal drugs
contraception and emergency contraception drugs specified in Schedule I of the Drug Schedules Regulation

Booking system

As of June 20, 2023, pharmacies can input their MACS appointment options into the soon-to-be-launched provincial booking system. Pharmacies can add information such as address, ailments assessed, appointment times, accessibility features, availability of parking and proximity to transit.

Once the booking system goes live for the public on June 29, 2023, pharmacies will be required to use it to manage MACS appointment bookings, rather than their own systems. Pharmacies are encouraged to also provide MACS to patients who come into the pharmacy without booking an appointment.

The MACS booking system is based on the GetVaccinated/ImmsBC booking system platform, and the pharmacist interface is very similar.

Pharmacies with ImmsBC admin access can now log in to ImmsBC Classic to input appointment details. To request access, visit the BC Immunization Portal on the BC Pharmacy Association (BCPhA) website.

The BCPhA has booking system training materials on their website. Consider signing up for the Zoom information session on June 26.


College of Pharmacists of BC: The College of Pharmacists of BC launched the PPMAC Regulatory Education module through UBC on May 5, 2023. The module is mandatory for pharmacists participating in MACS.

medSask: medSask’s “Minor ailment and self-care guidelines” can be accessed for free by B.C. pharmacists and pharmacy students through the BC Pharmacy Association (BCPhA) website. These guidelines aid decision-making by providing treatment algorithms and patient assessment and treatment checklists for each condition. medSask can be accessed with a BCPhA login. If you do not have a BCPhA account and/or are not a BCPhA member, you can sign up for a complimentary account. Please note that medSask materials may not reflect the standards, limits and conditions set out by the College of Pharmacists of BC, or PharmaCare requirements for the MACS fee.

UBC: Free accredited clinical education modules on several minor ailment conditions are available to licensed B.C. pharmacists through UBC’s Continuing Pharmacy Professional Development program (CPPD). To access these resources, visit the UBC MACS on Canvas course catalog

…and more to come:

  • An orientation training module on prescribing for minor ailments and contraception with a B.C. focus on PharmaCare requirements and practice requirements (BCPhA)
  • Accredited content on contraception and smoking cessation (summer 2023 – UBC)

Pharmacists are encouraged to seek out other educational opportunities and resources to help support their participation in the Minor Ailments and Contraception Service.

Q&As from the May 25, 2023 webinar

Q: Can pharmacies opt out of billing PharmaCare for a MACS provided in-pharmacy to a B.C. resident?

A: No, pharmacies cannot opt out of claiming PharmaCare-funded services in order to charge a patient directly, unless the pharmacy is not registered with PharmaCare (i.e., have opted out of all PharmaCare services, including drug billing). This is consistent with PharmaCare's Full Payment Policy.

Q:  Can a pharmacy charge patients directly for MACS if the patient is not eligible for MACS or if the service is out of scope?

A: Yes. Patients who are not eligible can choose to receive the service from pharmacies under a private-pay model. In this case, the pharmacy would use one of the non-benefit MACS PINs.

Q:  Do pharmacists need to complete the College training before providing MACS and claiming the MACS fee?

A: Yes

Q: Can pharmacy students provide MACS and claim the MACS fee?

A: No

Q: Does the PS intervention code need to be entered with every claim or just on the first dispense (if dispensed as part of a client's weekly blister pack)?

A: The PS intervention code should be entered on the first dispense and does not need to be entered again for refills. This is similar to using an intervention code for adaptation.

Q: Does the pharmacy need to remove the dispensing fee from each claim if they prescribe for weekly/daily dispensing?

A: Yes. Pharmacies will need to manually remove the dispensing fee or dispense the MACS Rx last, anticipating PharmaNet will reject the dispensing fee due to FOD limits. Note: if the dispensing fee is not claimed to PharmaCare, it will not be passed down to the third-party insurers, as PharmaCare is the first payor.

Q: If MR-PCN and MACS fees are claimed on same day, will MACS be paid?

A: Yes

Q: Are military personnel without MSP eligible for coverage for MACS?

A: Yes

Q: Can a pharmacist add refills when they prescribe?

A: Yes

Q:  Can a patient request a phone consult for MACS and ask their family member to pick up their medication for them?

A: Yes, but phone or virtual consults are not reimbursed by PharmaCare. When providing services that are not eligible for the MACS fee, pharmacists must use a non-benefit MACS PIN.

Q: Can a pharmacist prescribe for minor ailments and claim the MACS fee if they provide a consultation outside of the pharmacy (for example, as part of an in-home visit)?

A: Yes, if the following conditions are met.

  • The prescribing pharmacist is an employee or independent contractor of a PharmaCare-enrolled pharmacy that has PharmaNet access
  • The pharmacist checks PharmaNet while physically at the pharmacy before the offsite visit
    • If a pharmacist working offsite needs to re-check PharmaNet, they may call their pharmacy for someone onsite to check
    • No offsite (remote) access to PharmaNet is permitted
  • The pharmacist submits the claim at the PharmaCare-enrolled pharmacy on the day of the MACS assessment

Q: Is a pharmacy paid the MACS fee for consulting with a client about emergency contraception?

A: Yes. Pharmacists can use the contraception PINs for emergency contraception, if the patient wishes to have an assessment. Patients may also choose to self-select emergency contraception without a MACS, in which case, the fee may not be claimed.

A note about CareConnect

Pharmacists are not required to use CareConnect, but they are strongly encouraged to sign up, as it provides access to lab results that can be invaluable in informing a clinical assessment.