This article highlights state-level progress toward pharmacist reimbursement since the 2024 manuscript on this topic. A special thanks to the many AAPP members who assisted in the research and authorship of this manuscript which highlights expansion of pharmacist test-and-treat authority, new commercial coverage mandates, explicit Medicaid provider enrollment and reimbursement structures, and broadened scope-of-practice provisions tied to payment. Collectively, these developments reinforce the emergent bottom-up trajectory of pharmacist reimbursement reform and highlight the steady, incremental strengthening of pharmacist integration within state health systems.