Regulatory scrutiny
These products sit close to, sometimes inside, prescription drug regulation. The FDA declared the semaglutide and tirzepatide shortages resolved in early 2025, ending the broad compounding lane, with further restrictions pending.
Health & wellness
Payment Processing for Peptides, GLP-1 & Telehealth
We board licensed-pharmacy and legitimate Rx-model peptide, GLP-1, TRT, and telehealth programs, bank-sponsored and LegitScript-aware, with a published 5–9% rate range, reserves disclosed up front, and underwriting that reads the model, not the category label.
- Bank-sponsored & LegitScript-ready
- Published 5–9% range
- Rx-model underwriting
Answer first
The vertical everyone declines, underwritten properly
Peptides, GLP-1, TRT, and telehealth pharmacy are where mainstream processing simply stops. Stripe and PayPal won't touch it; most high-risk brokers either decline it or board it carelessly and disappear the moment the FDA shifts or a chargeback wave hits. The result is a market full of merchants running compliant, legitimate programs who can't get stable processing, and a smaller market of bad actors who give the whole category its reputation.
We board this vertical, but we're precise about how. We process for licensed-pharmacy and legitimate Rx-model programs, telehealth that connects patients to licensed prescribers, dispensing through licensed pharmacies, with real clinical gating, as approved by underwriting. We don't board research-only peptides marketed as treatments, or models that only worked during the drug shortage. The care we take at the front is the entire reason the account stays live at the back.
Why it's high risk
Three forces stack up to make this the hardest mainstream-declined vertical
Transaction economics
High-ticket, often recurring purchases are exactly the profile that generates disputes. High ticket plus recurring billing plus an emotionally charged product is a chargeback-ratio risk before anything goes wrong.
Marketing claims & flagged MCCs
Aggressive health and weight-loss claims draw regulators and brand-risk monitoring. Programs classify under MCCs 5122 (drugs & pharmaceuticals) and 5912 (drug stores & pharmacies), elevated-risk before a dollar settles.
Note
Regulatory status (reviewed 2026-06-10)
The regulatory status of compounded GLP-1 and peptide products is evolving, the FDA declared the semaglutide and tirzepatide shortages resolved in early 2025, has a 503B bulks-exclusion proposal open, and a peptide-bulks advisory is expected in 2026. We board licensed-pharmacy and Rx-model programs only, as approved by underwriting. This page is informational, not legal advice. For the current picture, see our compounded GLP-1 & peptides 2026 status page, which we review monthly.
Compliance
How we board it: the compliance framework
Boarding this vertical safely comes down to verifying four things. We confirm your pharmacy and prescriber relationships, that prescriptions come from licensed prescribers and dispensing runs through licensed pharmacies, not a fulfillment shortcut. We confirm your clinical model, genuine patient evaluation and gating rather than a checkout that ships a compounded product to anyone. We verify certifications, principally LegitScript for GLP-1, weight-loss, and prescription-adjacent telehealth models. And we review your marketing claims, because the fastest way to lose a peptide account is to advertise something the product isn't approved to do.
This is a sponsor-concurrence vertical: our sponsor bank pre-approves the merchant before the account is set up. That means more documentation and a longer timeline than a standard high-risk account, and we'd rather set that expectation honestly than promise a three-day turnaround on a three-week path. We board compounded peptide programs, GLP-1 weight-management programs, TRT, and telehealth-Rx platforms, all on the licensed-pharmacy or Rx model, all subject to underwriting approval.
Important
Enforcement update (reviewed 2026-06-15)
The FDA has escalated enforcement against non-compliant compounded GLP-1 sellers: 55+ warning letters issued in September 2025 targeting online sellers of compounded semaglutide, followed by a second wave in June 2026 focused on consumer-facing promotion. Separately, Medicare Part D began covering GLP-1 medications for weight management at $50/month starting July 1, 2026, which is reshaping the pricing landscape for direct-to-consumer telehealth. These developments reinforce the division we board on: licensed-pharmacy, Rx-model programs with genuine clinical gating are stable; shortage-era volume models and aggressive marketing are not. See our compounded GLP-1 & peptides 2026 status page for the full regulatory timeline.
GLP-1 in 2026
What the Medicare expansion and FDA enforcement mean for your processing
The GLP-1 landscape shifted twice in 2026, and both changes affect how a processor underwrites your account. The first is CMS: Medicare Part D now covers GLP-1 medications for weight management at a $50 monthly cap, which compresses the price ceiling for direct-to-consumer telehealth programs selling compounded or branded GLP-1s at $99–$348 a month. Programs that compete on price alone are losing ground to the pharmacy benefit; programs that compete on access, clinical quality, and a compliant Rx model are the ones processors can board with confidence.
The second is enforcement. The FDA's September 2025 warning-letter sweep and the June 2026 follow-up targeted sellers marketing compounded semaglutide directly to consumers without the clinical gating that distinguishes a pharmacy model from a volume play. For underwriting, the signal is that the regulatory floor keeps rising, and a merchant whose model depends on anything other than licensed prescribers, licensed pharmacies, and genuine patient evaluation is a compliance risk no responsible sponsor will carry. We track both tracks closely and update our boarding criteria as they move.
Rates & reserves
We publish the band
| Effective rate | Reserve | Requirement | |
|---|---|---|---|
| Rx-model peptide / TRT | 5%–7% + interchange | 10–15% rolling, tapering | Licensed pharmacy & prescriber |
| GLP-1 / telehealth-Rx | 7%–9% + interchange | 10–15% rolling, tapering | LegitScript + sponsor concurrence |
The range is higher than mainstream high-risk because the vertical combines regulatory scrutiny, high tickets, and recurring billing. Any processor quoting a mainstream rate for a GLP-1 program is either mispricing the risk or planning to drop you. Final rate is set by underwriting. See full pricing →
How approval works
Underwritten before boarding, not after
1
You apply
Business and licensing details, pharmacy and prescriber relationships, LegitScript certification or your plan to obtain it, prior statements, and a clear description of your clinical and fulfillment model.
2
AI screens the risk
Velocity, device and behavioral signals tuned to the high-ticket, recurring failure modes that drive disputes in this vertical.
3
A human decides
An underwriter reviews your prescriber and pharmacy model, certifications, and claims, then writes the decision, rate and reserve in writing.
4
You go live
We connect your gateway and recurring billing. Sponsor concurrence pre-approves the merchant, so expect added review time, set up front.
A written decision
You see exactly where your file stands
No black-box “no.” Underwriting tracks every requirement to completion and issues a written memo: why you were approved, your rate, and any reserve with its taper, visible before you go live.
- Onboarding checklist tracked to 100%
- Reserve %, hold period and taper in writing
- Pharmacy, prescriber and claims reviewed up front
FAQ
Peptide & GLP-1 processing FAQ
Which payment processor handles peptide and GLP-1 payments?
GivePayments boards peptide, GLP-1, TRT, and telehealth-pharmacy programs that operate on a compliant, licensed-pharmacy or Rx model, as approved by underwriting. We're a US, bank-sponsored high-risk processor with published rate ranges (5–9% for this vertical), reserves in the 10–15% range, AI chargeback defense, and a LegitScript-aware onboarding path. We underwrite the model before boarding, so the account that goes live is one built to stay live.
Can telehealth pharmacies accept cards for GLP-1 or semaglutide?
Yes, when the program runs on a compliant footing: licensed prescribers, dispensing through licensed pharmacies, genuine clinical gating, and accurate marketing claims. What changed in 2025 is that the broad shortage-era compounding lane closed when the FDA declared the semaglutide and tirzepatide shortages resolved. Legitimate Rx-model telehealth still processes cards; underwriting examines your prescriber and pharmacy relationships, certifications, and claims before boarding.
Is peptide payment processing legal in the US?
Processing payments for a peptide business is legal when the underlying business is legal. That hinges on your model: licensed-pharmacy and legitimate Rx programs are boardable, while research-only peptides sold as treatments, or models that depend on the closed shortage-era compounding lane, are not. The regulatory picture is evolving, the FDA issued 55+ warning letters to non-compliant compounded GLP-1 sellers in September 2025 and a second wave in June 2026, and Medicare Part D began covering GLP-1s at $50/month in July 2026. See our GLP-1 and peptide 2026 status page, which is why we underwrite the specific model rather than the category label.
What documentation is needed to process TRT or peptide payments?
Expect to provide your business and licensing details, your pharmacy and prescriber relationships, LegitScript certification where it applies, prior processing statements if you have them, and a clear description of your clinical and fulfillment model. Because this is a sponsor-concurrence vertical, the sponsor bank pre-approves the merchant, so the file is more detailed and the timeline longer than a standard high-risk account. We tell you exactly what's needed before you start.
How much does peptide and GLP-1 payment processing cost?
Our published range for this vertical is 5–9%, with rolling reserves typically 10–15%, and your final rate is set by underwriting based on your model, volume, average ticket, and chargeback history. The range is higher than mainstream high-risk because the vertical combines regulatory scrutiny, high tickets, and recurring billing. We publish the band up front rather than hiding it behind a sales call.
Do I need LegitScript certification to process peptide or GLP-1 payments?
For GLP-1, weight-loss, and prescription-adjacent telehealth models, effectively yes, both ad platforms and processors increasingly gate on it, and our sponsor banks require it for those models. Some peptide models depend on what's sold and how it's marketed. We'll tell you at the application stage whether your specific program needs certification, and our LegitScript guide walks through the pathway, cost, and timeline.
Related
Keep exploring
Board the compliant model that stays live.
If you run a compliant, licensed-pharmacy or Rx-model peptide, GLP-1, TRT, or telehealth program, that's exactly the business we're built to board. We won't promise easy approval, we'll promise a real underwriting conversation and a written decision.