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 9, 2023

New s

- Nutrition-Related Health Conditions: Recommend Medicare Preventive Services

Com pliance

- Advance Care Planning: Bill Correctly for Services

Claim s, Pricers, & Codes

- Medicare Physician Fee Schedule Database: April Update

- Home Health Prospective Payment System Grouper: April Update

Event s

- Ambulance Open Door Forum: Medicare Ground Ambulance Data Collection System ? March 16

MLN Mat t ers®Art icles

- Extension of Changes to the Low-Volume Hospital Payment Adjustment & the Medicare Dependent Hospital Program

- National Coverage Determination: Cochlear Implantation

- Patient Driven Payment Model: Claim Edit Enhancements ? Revised

Publicat ions

- Medicare Part B Inflation Rebate Guidance: Use of the 340B Modifier ? Revised