<h3>Objectives</h3> We sought to understand the steps states have taken to promote pharmacist prescribing of hormonal contraception, including implementation challenges and facilitators. <h3>Methods</h3> We conducted a qualitative study of interviews with 18 key stakeholders from 10 states with pharmacist prescriptive hormonal contraceptive authority. We used relevant constructs from the Consolidated Framework for Implementation Research (CFIR) to develop an interview guide that explored participants' experiences with implementation of pharmacist prescribing of hormonal contraception including facilitators, barriers, and potential approaches to promote implementation. We analyzed data using directed qualitative analysis principles and compared experiences across states. We organized the data using the CFIR framework and explored the facilitators of and barriers to states' implementation efforts. <h3>Results</h3> We interviewed 10 individuals from the state Pharmacist Association or Board of Pharmacy, six community pharmacists, and two individuals from Medicaid offices. Participants identified four key steps to implement pharmacist prescribing at the state level: development of reimbursement and billing mechanisms for pharmacist time, creation of state rules and regulations, development of educational programs for pharmacists, and expansion strategies for pharmacists and pharmacies. Participants identified early involvement of key stakeholders and a culture of support for clinician pharmacists as facilitators to implementation. Challenges included complexity and cost of billing mechanisms, lack of funding for implementation efforts, and competing priorities of stakeholders. <h3>Conclusions</h3> States implementing pharmacist prescribing of hormonal contraception should prioritize strategies to overcome reimbursement and billing challenges early in their efforts to expand contraceptive access.