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, March 30, 2023

New s

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COVID-19: Booster Dose for Children 6 months ? 4 years

- Identity & Access Management System: Easier for Surrogates

- Medicare Advantage Value-Based Insurance Design Model Extended

- Supplemental Security Income & Medicare Beneficiary Data: FY2021

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DMEPOSfor Skilled Nursing Facility: Pre-Discharge Delivery for Fitting & Training

Claim s, Pricers, & Codes

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COVID-19: Reporting CRModifier & DRCondition Code After Public Health Emergency

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April 2023 Quarterly Pricing File Revisions

MLN Mat t ers® Art icles

- Medicare Part B Coverage of Pneumococcal Vaccinations

- Supervision Requirements for Diagnostic Tests: Manual Update

Publicat ions & Mult im edia

- Post-Acute Care Quality Reporting Program: Videos & Patient Cue Cards