ALL FACILITIESREQUIRED TO REPORT340B MODIFIERSIN 2024

This is a substantial change from the original 340B billing requirement Previously, Critical Access Hospitals and Maryland All-Payer or Total Cost of Care Model hospitals were not required to report a modifier on 340(B) drugs. CMSissued a companion ?FAQ?document which reiterates this point: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HospitalOutpatientPPS/ Downloads/Billing-340B-Modifiers-under-Hospital-OPPS.pdf

ALL FACILITIESREQUIRED TO REPORT340B MODIFIERSIN 2024

The FAQ document provides a table summarizing the requirement for affected provider types:

The modifier requirement does not apply to all drugs purchased under 340(B), although hospitals may opt to report the modifier for all 340B drugs. The obligation to append a modifier applies to only Part B drugs and biologicals assigned OPPSStatus Indicator G or K(?separately payable?under OPPS.)

PARA Dat a Edit or users may identify the line items within the hospital charge master which are separately payable drugs by navigating to the ?Filters?tab, clicking the checkbox next to ?Status Indicator?, and clicking on both status G and status K, as illustrated below:

PARA invit es you t o check out t he m lnconnect s page available from t he Cent ers For Medicare and Medicaid (CMS). It 's chock full of new s and inform at ion, t raining opport unit ies, event s and m ore! Each w eek PARA w ill bring you t he lat est new s and links t o available resources. Click each link for t he PDF!

Thursday, April 20, 2023

New s

- Billing Medicare Part B for Insulin with New Limits on Patient Monthly

Coinsurance

- Medical Review & Compliance: Respond to Additional Documentation

Requests

- Hospice: Comparative Billing Report in April

Com pliance

- Home Health Rural Add-On Policy

Claim s, Pricers, & Codes

- Grandfathered Tribal Federally Qualified Health Centers: CY2023 Rate

Event s

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Medicare Ground Ambulance Data Collection System: Office Hours Session ? April 27

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Medicare Shared Savings Program: Navigating the Application Webinar ?

May 8

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Clinical Laboratory Fee Schedule: Present or Speak at Upcoming Meetings