MISSOURI MPJE EXAMINATION TEST 2025/2026
QUESTIONS WITH ANSWERS RATED A+
✔✔Other Equipment Required? - ✔✔Hot and cold water supply within the pharmacy
and appropriate reference manuals
"Basic equipment recognized by the latest edition of the United States Pharmacopoeia
(USP), the United States Pharmacopoeia/Drug Information (USP/DI) or Remington's
Pharmaceutical Sciences shall be available..."
Current reference manuals
Current Statutes and Rules
Appropriate drug storage with temperature monitoring devices/thermometer, adequate
refrigeration/freezer units per USP
✔✔Special Rules on Automated Dispensing Cabinets? - ✔✔Automated Dispensing
Systems
● Located where permit exists, physically or remotely monitored (via constant video and
audio communication) by pharmacist.
● Remote systems may only dispense for prescriber providing services at that location.
● Documentation of all access, activity, and transactions must be maintained.
● Cabinets maintaining controlled substances require perpetual inventory.
● Adequate space and privacy required for consultation with minimum 12" wide video
monitor in ambulatory settings.
Automated Filling Systems (20 CSR 2220-2.950(4)(G)):
● Daily random quality control testing required on 2+% of prescriptions
✔✔Must RPh Be On-Site for Access to Pharmacy? - ✔✔Yes
✔✔After Hours Dispensing Allowed? Requirements (i.e. Dispensing Cabinet? -
✔✔Licensed pharmacist must be present
✔✔Emergency Access to Pharmacy Procedures? - ✔✔Licensed pharmacist must be
present
✔✔Mail Allowed? (In-State to Out, Out-of-State to In) - ✔✔Prescriptions filled for a
specific patient may be delivered upon the patient's/authorized designee's request to
residence, LTC, hospital/clinic/office of practitioner authorized to prescribe, patient's
place of employment (20 CSR 2220-2.013(2))
Nonresident pharmacies must obtain MO pharmacy license to ship/mail/deliver
prescriptions into MO except in emergency or upon refill of previously filled Rx within
original state where pharmacy is located
✔✔To be valid, a telehealth or telemedicine prescription must meet these requirements:
- ✔✔• The prescriber must be licensed to practice in Missouri, and
• The prescription must be based on a valid prescriber-patient relationship, and
,• The prescription must comply with all other state/federal prescription requirements,
including, 20 CSR 2220-2.018, § 338.056 and any applicable controlled substance laws,
and
The telemedicine services must be within the provider's "scope of practice" and meet
the applicable standard of care
✔✔A telemedicine prescription CANNOT be filled if - ✔✔• No legitimate practitioner-
patient relationship exists, or
• The prescription was issued based solely on an internet request or an internet
questionnaire, or
The prescription was based solely on a telephone evaluation without a previously
established and ongoing prescriber-patient relationship
A pharmacist shall not dispense a prescription drug if the pharmacist has knowledge, or
reasonably should know under the circumstances, that the prescription order for such
drug was issued on the basis of an Internet-based questionnaire or without a valid
preexisting patient-practitioner relationship
✔✔Ownership requirements - What Are the Fees for A Pharmacy License? -
✔✔Original Pharmacy Permit Fee $300
Renewal Fee $450
Duplicate License/Permit/Registration $20
✔✔Who Can Apply? Ownership - ✔✔Owners can be a person, firm, corporation,
partnership, pharmacist
✔✔Must be RPh to Own Pharmacy? - ✔✔If applicant is not a Missouri licensed
pharmacist in good standing, one that is must complete the PIC affidavit of the permit
application
✔✔Additional Requirements for Ownership? - ✔✔Application process must be
completed within 6 months of initial application
✔✔Rules on Sales/Transfers - Ownership - ✔✔Upon change of ownership, date of
change voids original permit and new permit must be obtained prior to operation
Upon death of proprietor, estate may operate for up to 1 year if permit is paid and in
good standing
✔✔Application/Fees Required? - Ownership - ✔✔Change of Name Fee $25
Change of Location Fee $175
✔✔Types of Pharmacy Permits? - ✔✔Class A: Ambulatory and Community
Class B: Hospital (owned/managed/operating by hospital or clinic/facility under hospital
system that is not otherwise under Missouri DHSS)
Class C: Long-Term Care (dispensing to patients in LTCF)
, Class D: Non-Sterile Compounding
Class E: Radiopharmaceutical (for locations preparing/compounding/storing/dispensing
nuclear chemicals classified as legend drugs)
Class F: Renal Dialysis (limited to dialysis solutions and associated supplies/drugs)
Class G: Medical Gas (prescription gases for therapeutic use)
Class H: Sterile Compounding
Class I: Consultant (pharmacy practice without possession of medications)
Class J: Shared Services (multiple locations to complete pharmacy activities)
Class K: Internet (90% of new Rx volume originating from the internet)
Class L: Veterinary (if only providing services for animals)
Class M: Bleeding Disorders/Specialty (providing blood-clotting products/infusion
equipment/supplies)
Class N: Healthcare Facility Automated Dispensing System
Class O: Ambulatory Automated Dispensing System
Class P: Pharmacies Operating in Practitioner Office/Clinic
Class Q: Charitable Pharmacy
Class R: Remote Dispensing Site Pharmacy
✔✔How Long for Notification Period? - Ownership changes/Business termination -
✔✔Notify the board within 10 days of change in partners of limited liability ownership,
30 days to notify of gaining more than 25% of entity owning pharmacy (20 CSR 2220-
2.020(3)(B-C))
Notify the board of business termination within 15 days
Upon termination of business, permit must be returned to board for cancellation or
destruction
✔✔RPh-Tech Ratio? Different by Setting? RPh-Intern Ratio? Different by Setting? RPh-
Staff (Clerk/Delivery Driver/Cashier) Ratio? Different by Setting? - ✔✔Missouri does not
mandate a staffing ratio (e.g., pharmacist-to-technician)
✔✔Is Facility Licensure Required for General Compounding? Sterile Compounding? -
✔✔Class D Non-Sterile Compounding License (20 CSR 2220-2.400)
Class H Sterile Product Compounding License
✔✔Restrictions on Compounding Without Prescription? - ✔✔"Compounding of any drug
product to be sold without a prescription is prohibited."
✔✔Stability of Compounded Product? - ✔✔Sterile compounding:
Beyond-use dating for Risk Levels 1 and 2 based on "stability information and sterility
considerations." Risk Level 3 may be based on laboratory testing or other reliable
method, limited to 30 days unless lab/instrumental analysis validates stability and
potency beyond (20 CSR 2220-2.200(13))
Beyond use dating for non-sterile compounds is ingredient-dependent, assigned based
on different criteria (20 CSR 2220-2.400(4))
QUESTIONS WITH ANSWERS RATED A+
✔✔Other Equipment Required? - ✔✔Hot and cold water supply within the pharmacy
and appropriate reference manuals
"Basic equipment recognized by the latest edition of the United States Pharmacopoeia
(USP), the United States Pharmacopoeia/Drug Information (USP/DI) or Remington's
Pharmaceutical Sciences shall be available..."
Current reference manuals
Current Statutes and Rules
Appropriate drug storage with temperature monitoring devices/thermometer, adequate
refrigeration/freezer units per USP
✔✔Special Rules on Automated Dispensing Cabinets? - ✔✔Automated Dispensing
Systems
● Located where permit exists, physically or remotely monitored (via constant video and
audio communication) by pharmacist.
● Remote systems may only dispense for prescriber providing services at that location.
● Documentation of all access, activity, and transactions must be maintained.
● Cabinets maintaining controlled substances require perpetual inventory.
● Adequate space and privacy required for consultation with minimum 12" wide video
monitor in ambulatory settings.
Automated Filling Systems (20 CSR 2220-2.950(4)(G)):
● Daily random quality control testing required on 2+% of prescriptions
✔✔Must RPh Be On-Site for Access to Pharmacy? - ✔✔Yes
✔✔After Hours Dispensing Allowed? Requirements (i.e. Dispensing Cabinet? -
✔✔Licensed pharmacist must be present
✔✔Emergency Access to Pharmacy Procedures? - ✔✔Licensed pharmacist must be
present
✔✔Mail Allowed? (In-State to Out, Out-of-State to In) - ✔✔Prescriptions filled for a
specific patient may be delivered upon the patient's/authorized designee's request to
residence, LTC, hospital/clinic/office of practitioner authorized to prescribe, patient's
place of employment (20 CSR 2220-2.013(2))
Nonresident pharmacies must obtain MO pharmacy license to ship/mail/deliver
prescriptions into MO except in emergency or upon refill of previously filled Rx within
original state where pharmacy is located
✔✔To be valid, a telehealth or telemedicine prescription must meet these requirements:
- ✔✔• The prescriber must be licensed to practice in Missouri, and
• The prescription must be based on a valid prescriber-patient relationship, and
,• The prescription must comply with all other state/federal prescription requirements,
including, 20 CSR 2220-2.018, § 338.056 and any applicable controlled substance laws,
and
The telemedicine services must be within the provider's "scope of practice" and meet
the applicable standard of care
✔✔A telemedicine prescription CANNOT be filled if - ✔✔• No legitimate practitioner-
patient relationship exists, or
• The prescription was issued based solely on an internet request or an internet
questionnaire, or
The prescription was based solely on a telephone evaluation without a previously
established and ongoing prescriber-patient relationship
A pharmacist shall not dispense a prescription drug if the pharmacist has knowledge, or
reasonably should know under the circumstances, that the prescription order for such
drug was issued on the basis of an Internet-based questionnaire or without a valid
preexisting patient-practitioner relationship
✔✔Ownership requirements - What Are the Fees for A Pharmacy License? -
✔✔Original Pharmacy Permit Fee $300
Renewal Fee $450
Duplicate License/Permit/Registration $20
✔✔Who Can Apply? Ownership - ✔✔Owners can be a person, firm, corporation,
partnership, pharmacist
✔✔Must be RPh to Own Pharmacy? - ✔✔If applicant is not a Missouri licensed
pharmacist in good standing, one that is must complete the PIC affidavit of the permit
application
✔✔Additional Requirements for Ownership? - ✔✔Application process must be
completed within 6 months of initial application
✔✔Rules on Sales/Transfers - Ownership - ✔✔Upon change of ownership, date of
change voids original permit and new permit must be obtained prior to operation
Upon death of proprietor, estate may operate for up to 1 year if permit is paid and in
good standing
✔✔Application/Fees Required? - Ownership - ✔✔Change of Name Fee $25
Change of Location Fee $175
✔✔Types of Pharmacy Permits? - ✔✔Class A: Ambulatory and Community
Class B: Hospital (owned/managed/operating by hospital or clinic/facility under hospital
system that is not otherwise under Missouri DHSS)
Class C: Long-Term Care (dispensing to patients in LTCF)
, Class D: Non-Sterile Compounding
Class E: Radiopharmaceutical (for locations preparing/compounding/storing/dispensing
nuclear chemicals classified as legend drugs)
Class F: Renal Dialysis (limited to dialysis solutions and associated supplies/drugs)
Class G: Medical Gas (prescription gases for therapeutic use)
Class H: Sterile Compounding
Class I: Consultant (pharmacy practice without possession of medications)
Class J: Shared Services (multiple locations to complete pharmacy activities)
Class K: Internet (90% of new Rx volume originating from the internet)
Class L: Veterinary (if only providing services for animals)
Class M: Bleeding Disorders/Specialty (providing blood-clotting products/infusion
equipment/supplies)
Class N: Healthcare Facility Automated Dispensing System
Class O: Ambulatory Automated Dispensing System
Class P: Pharmacies Operating in Practitioner Office/Clinic
Class Q: Charitable Pharmacy
Class R: Remote Dispensing Site Pharmacy
✔✔How Long for Notification Period? - Ownership changes/Business termination -
✔✔Notify the board within 10 days of change in partners of limited liability ownership,
30 days to notify of gaining more than 25% of entity owning pharmacy (20 CSR 2220-
2.020(3)(B-C))
Notify the board of business termination within 15 days
Upon termination of business, permit must be returned to board for cancellation or
destruction
✔✔RPh-Tech Ratio? Different by Setting? RPh-Intern Ratio? Different by Setting? RPh-
Staff (Clerk/Delivery Driver/Cashier) Ratio? Different by Setting? - ✔✔Missouri does not
mandate a staffing ratio (e.g., pharmacist-to-technician)
✔✔Is Facility Licensure Required for General Compounding? Sterile Compounding? -
✔✔Class D Non-Sterile Compounding License (20 CSR 2220-2.400)
Class H Sterile Product Compounding License
✔✔Restrictions on Compounding Without Prescription? - ✔✔"Compounding of any drug
product to be sold without a prescription is prohibited."
✔✔Stability of Compounded Product? - ✔✔Sterile compounding:
Beyond-use dating for Risk Levels 1 and 2 based on "stability information and sterility
considerations." Risk Level 3 may be based on laboratory testing or other reliable
method, limited to 30 days unless lab/instrumental analysis validates stability and
potency beyond (20 CSR 2220-2.200(13))
Beyond use dating for non-sterile compounds is ingredient-dependent, assigned based
on different criteria (20 CSR 2220-2.400(4))
