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 6, 2023

New s

- Resources & Flexibilities to Assist with Public Health Emergency in Mississippi

Due to Recent Storms

- Program for Evaluating Payment Patterns

Electronic Reports

- Advance Beneficiary Notice of Noncoverage: Form Renewal

- New Recovery Audit Contractor for Region 2 Starting Spring 2023

- Comprehensive Error Rate Testing Review Contractor Company Changed

Name

- Help Improve the Health of Minority Populations

Claim s, Pricers, & Codes

- RARCs, CARCs, Medicare Remit Easy Print, & PCPrint: April Update

Event s

-

PCG Provider Compliance Focus Group: Provider Compliance Activities

Post-PHE? May 9

MLN Mat t ers®Art icles

- Hospital Outpatient Prospective Payment System: April 2023 Update ?