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Refill Policy


If nothing is ready at your pharmacy 3 business days after you submit a refill request:

Confirm with your pharmacy that:

  • Dr. McCarthy's request has been received (pharmacy backlog sometimes prevents this)

  • The medication is in stock

Keep Dr. McCarthy updated 703•288•3535


All refill requests should be made during your appointment.

Dr. McCarthy will make arrangements during your appointment to ensure you have medication to last until your next visit (up to 3 months max).

If you have not had an appointment within three months, Dr. McCarthy will be unable to fill your prescription.

Federal law does not allow physicians to prescribe “controlled” substances (including most medicines for ADHD) unless patients have been seen within three months.

NO WORRIES if you are a current patient and you are “out-of-sync” with the 3-Month appointment schedule

When you submit your refill request, you will also schedule the next available appointment.: In compliance with federal regulations, and to minimize prescription delays, the next available appointment may be scheduled as a “parent-only” visit in my office or by telemedicine, especially if a child patient is unavailable.

The refill “arrangements” that Dr. McCarthy makes during your appointment can vary widely depending on the situation

The way you and Dr. McCarthy set up refills depends on many factors. Arrangements may also change due to ongoing shortages, prior authorization hassles, and ever-changing insurance formularies. The rules about refills vary significantly between states.


Although the refill request form uses a secure administrative email server, it is not HIPPA compliant. Nonetheless, most patients prefer this system. It is entirely up to you and your cybersecurity comfort level. Alternatively, you are ALWAYS welcome to call the Office at 703•288•3535 for refills and leave a confidential voicemail for Dr. McCarthy or her director. This voicemail method was Dr. McCarthy’s previous longstanding refill policy, and it worked marvelously well before the medication shortage.

Refill Requests

(it's more complicated due to the shortage)

1. Call your pharmacy to confirm the medication is in stock.

2. Submit an online refill request and notify Dr. McCarthy 703•288•3535.

3. Keep checking with the pharmacy after 2 business days (can take 3) to confirm:

  • The prescription was received (pharmacy backlog sometimes prevents this)

  • The prescription has been filled and is not in "backorder limbo."

4. Give Dr. McCarthy voicemail updates 703•288•3535.

Current patients can submit a refill request by confirming an appointment has been scheduled (the confirmation is part of the request form).


The medication shortage often requires extensive additional physician processing time per additional refill. Three business days notice means that if you request a refill on a Saturday, it will be processed and sent to your pharmacy by the following Wednesday or Thursday. Outside of legitimate emergencies, REFILLS WILL NOT BE PROCESSED ON WEEKENDS OR AFTER BUSINESS HOURS. Dr. McCarthy must be at her secure prescribing office hours (M-F, 7:30-5:30) to submit electronic prescriptions. The old days of “call-ins” are no more. Soon electronic prescriptions will be required for all prescriptions and paper ones will be obsolete. Electronic prescribing is already the rule in most states and for controlled medications.

Call your Pharmacy after 3 business days (M-F) to confirm your Refill is Ready for Pickup

Dr. McCarthy is meticulous about sending prescriptions for compliant patients within her 3-business-day response window. After 3 business days from submitting your refill request, start contacting your pharmacy for status updates. Do not rely on your pharmacy to contact you, even if you are signed up for autmatic notifications. Be prepared to reach out repeatedly if necessary.

Unfortunately, the system used to send the prescriptions electronically is far from perfect, and on some occasions, even though everything checks out on Dr. McCarthy's end, the prescription seems to disappear into some sort of electronic Bermuda Triangle. Always call the pharmacy FIRST to confirm it is ready before calling Dr. McCarthy. If your pharmacy says they do not have your prescription after the 3 days have passed, PLEASE CALL Dr. McCarthy at her office immediately at 703•288•3535, and follow emergency contact instructions, so she can resubmit the prescription that was seemingly erased from the pharmacy electronic system. She will resubmit the refill that VERY SAME business day (M-F). The same goes for any other electronic prescribing snafus that you encounter.


We appreciate your patient understanding during such frustrating instances. There is nobody who wants your prescription filled efficiently more than Dr. McCarthy!

$25 processing fee for repeated prescription requests and pharmacy reroutes outside of appointment times

Processing fees will be automatically billed to your credit card to cover Dr. McCarthy's time to process, submit, and document multiple electronic refills and pharmacy reroutes not planned during a regularly scheduled appointment.

Due to increased DEA regulations, charges for clinical time may also apply for extensive prior authorization processing.

Any new prescription requests not addressed during appointment times are granted on a case-by-case basis. This includes requests for frequent pharmacy changes, backorder/stock problems, camp med changes, lost prescriptions, or extra medicine from missed appointments outside of the policy window of three months.

No additional charge for treatment dosage adjustments or refills arranged at an appointment within past 3 months

If Dr. McCarthy decides to adjust your dose for titration between appointments or change your medication altogether, this is part of your treatment plan. If there are back-order issues out of your control for camp medications discussed during your appointment, or insurance mail order problems, no worries either. Always remember Dr. McCarthy wants to partner with you and reduce your stress level as much as humanly possible.


Texts are not HIPAA-secure most likely will not be seen by Dr. McCarthy, and can cause delay.


Review the full Refill Policy, starting at the top of this page, to be sure you understand it. Ask her if you have questions.

Switching pharmacies sometimes is ODDLY complicated

Switching pharmacies can EASILY be done DURING your appointment time or with plenty of notice before the next prescription is next due. There can be only ONE pharmacy address under your name in the system. Sometimes certain pharmacies run out of certain medications, and we MUST switch pharmacies: no worries, we can do this, but it can be tricky, so read below.


Since there can only be one pharmacy in the system per patient, changing pharmacies can result in confusion for filling future prescriptions, often messes up the electronic system, and has bigger issues transfer involving out-of-state pharmacies. Thus, always remind Dr. McCarthy of your current pharmacy during your appointment to be sure any previous changes have not caused prescriptions to go rogue to default pharmacies.

If you lose your medicine or forget your prescription on vacation, be aware that certain states (for example CA, HI, and TX) NEVER allow doctors not licensed in their state to prescribe in their state. So, if you forget to bring your medicine to Hawaii, your need to figure out how to have a friend FedEx your home prescription. Other states will allow emergency short-term refills through an override appeal through Dr. McCarthy. Your insurance will likely make you pay out of pocket for the extra medicine early refill override. On these occasions (same business day urgent unusual prescription needs) leave a voice mail on Dr. McCarthy’s office number 703•288•3535. During office hours (M-F), she will immediately process your vacation override short-term refill if allowed by the DEA.

If you are scheduled to be away/out of town when your medicine refill is due

Easy Peezie. You can get a vacation override for an early refill so long as you plan ahead. Call Dr. McCarthy and she will order your medication with a “vacation override” request. Usually, the pharmacy calls the insurance company to facilitate this after Dr. McCarthy places the override order, but sometimes the insurance company creates roadblocks. In this case, you will need to call the insurance company to raise a ruckus and explain why you need the medicine early.

If you need an extended refill (e.g., for a trip to study abroad), you need to first call your insurance company to figure out their policy about this and tell Dr. McCarthy what to do. This can be highly time-consuming (like calling an airline to make changes), so plan ahead. If you get a representative who seems to be clueless, call back and get someone else. After you have clearance from your insurance company, along with instructions, Dr. McCarthy will follow orders once you tell her what to do.

Controlled substance Policy (Most ADHD meds)


Some of the most evidence-based, safe, rigorously researched, and optimal medications for ADHD are called “stimulants.” A few of them have been around for nearly 90 years! Nonetheless, these medications are considered “controlled substances,” and they are tightly regulated by the DEA. Therefore, the rules below must be strictly followed for these medications:

All patients who are prescribed controlled substances (most ADHD meds) must agree to the following policy, which is based on federal law:

  • THREE-MONTH APPOINTMENT MINIMUM. Patients must see Dr. McCarthy at least every three months. Instead of canceling, it is advisable to keep the appointment by phone or as a parent telemedicine appointment to stay within the three-month DEA refill window.

  • NO EARLY REFILLS. Medications must be taken as directed and cannot be refilled before their refill date. There are no exceptions, even for lost or stolen prescriptions or if you run out early. As frustrating as these very human incidents can be, this federal law is sadly out of Dr. McCarthy’s control.

  • NO DOSE CHANGES ON YOUR OWN. If you believe the medication may be ineffective, you must first consult with Dr. McCarthy before making any changes. If you run out of medication early from taking extra doses on your own, Dr. McCarthy cannot refill it. Additionally, patients who self-adjust their dose will likely be referred out of Dr. McCarthy’s practice.

Controlled substances medication cannot be “called in” from anywhere at any time

Controlled Medications must be ordered electronically from the secure server and computer in Dr. McCarthy’s office during business hours only (M-F, no evenings or weekends)

Prescriptions and refills cannot be sent outside of office hours. This “weekend rule” applies to all medications, but it is absolutely unbendable for ADHD medications because of the complicated security process requiring that such prescriptions be sent through a secure server. These prescriptions can only be refilled by Dr. McCarthy herself.

Out-of-State Restrictions (California, Hawaii, Texas)

Mail-order pharmacies and 90-Day Prescriptions

Some states prohibit physicians not licensed in that state from prescribing controlled substances there (California, Hawaii and Texas). This applies to Dr. McCarthy, so she cannot send prescription orders to those states.

For those lucky few who’s insurance still allows 90-day controlled substance refills by mail, Dr. McCarthy will happily send your prescription during your appointment. Please note that a three-month prescription is the DEA-mandated limit, and Dr. McCarthy cannot to send other prescriptions locally. To ensure all goes well with your 90-day order, please follow these steps:

Before your appointment

• Confirm your insurance allows 90-day refills for your medication.

• Confirm your mail order pharmacy has your medication dose and quantity in stock.

After your appointment

• Confirm with your mail order pharmacy that the order has been received and that payment has been arranged.

Prior Authorzations

Pesky Prior Authorization (PAs)

Although many insurers exclude top ADHD medications from their formularies, Dr. McCarthy and her team will advocate relentlessly on your behalf to ensure your needs are met. If your insurance requires a prior authorization (PA), Dr. McCarthy’s team will submit a request to your insurer within 48 business hours. However, response times depend on the insurance company, and approvals can sometimes take over a week. 

Nonetheless, the bottom line is this: Even after granting a PA, the insurance company still might not authorize the medication, especially if they demand “step” care with their formulary. In effect, sometimes, the insurance company insists on managing the treatment plan.


If difficult PAs require Dr. McCarthy’s repeated extensive time (>10 min) interacting with your insurance company, that time will be billed at the standard session rate. For example, very rarely, insurance companies demand extended telephone calls (“peer-to-peer” appointments). This requires Dr. McCarthy to schedule an appointment with the insurance company doctor to explain your medication treatment plan.

Abuse Potential and Dangerous Combo with “Real Drugs”

Because of the abuse potential, most ADHD medications, like pain medications, are “Controlled Substances” by the DEA and Federal Law. The government tightly controls these medications for multiple reasons, but largely due to the risk of abuse. Unfortunately, there is an enormous problem with the diversion and abuse of these medications by people who have never been diagnosed with ADHD. For example, students sometimes sell their medication on college campuses. Dr. McCarthy has not known of her ADHD patients in 25 years to have abused these types of meds. However, she has known patients who sold the medication she prescribed, thereby permanently jeopardizing their ability to receive future prescriptions and risking injury or death to other individuals for whom it was never prescribed.

Furthermore, combining these and other psychiatric medications with alcohol, marijuana, or illicit substances that also cross the blood-brain barrier can have dangerous and lethal effects. Dr. McCarthy requires a commitment to wellness for teens and young adults who want to work with her to get better. This includes a contract stating that they will not abuse substances while taking the medication she prescribes. Dr. McCarthy now routinely orders drug screens as part of ensuring wellness, safety, and treatment compliance. In the future, she will likely test randomly during office visits. Medications cannot work if toxic substances are competing for target brain receptors.

Furthermore, alcohol and marijuana cause damage to developing brains, including the hippocampus and white matter. Such damage can cause learning disabilities, lower IQ, and more serious, irreversible psychiatric conditions. Finally, brand-new research shows that marijuana and even CBD can cause elevated or even toxic levels of many psychiatric medications, including most of the medications Dr. McCarthy prescribes. This means amplified side effects or potentially dangerous adverse effects. Marijuana also affects the efficacy of anxiety and depression medicine and scrambles the neurotransmitter and nerve cell receptor pathways, thus making treatment response less possible. Knowing these findings, Dr. McCarthy works in a compassionate, non-preachy, and motivational manner to help support today’s teens who grow up in an increasingly stressful environment where drug use is normalized around them.

Final notes about prescriptions

Dr. McCarthy is meticulous about refills and takes great pride and responsibility to ensure she will give you enough medication to last you until your next visit. Her goal is to reduce your stress and worries and make refills as seamless as possible.

REMEMBER: If there are problems with any refill, first call Dr. McCarthy IMMEDIATELY at the Office Number 703•288•3535, and follow emergency contact instructions to reach her immediately.

Current patients can submit a refill request if they confirm that an appointment has been scheduled (the confirmation is part of the request form).

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