Revised Policy for Discarded Part B Drugs Took Effect on Jan. 1, 2017

A revised policy regarding the use of the JW modifier took effect on Jan. 1, 2017. The JW modifier is used on a Medicare Part B drug claim to report the amount of drug or biological that is discarded and eligible for payment under the discarded drug policy.

Physicians and other health care providers are currently required to:

  • Use the JW modifier for claims with unused drugs or biologicals from single use vials or single use packages that are appropriately discarded
  • Document the discarded drugs or biological in the patient's medical record when submitting claims with unused Part B drugs or biologicals from single use vials or single use packages that are appropriately discarded.

Novitas Solutions confirms that the JW modifier is not required for drugs that are not separately payable, such as packaged Outpatient Prospective Payment System drugs or drugs administered in the Federally Qualified Health Center or Rural Health Clinic setting, or drugs paid under the Part B drug Competitive Acquisition Program.

More Resources

These resources offer further clarification on the JW modifier:

PAMED members with questions can call our Knowledge Center at 855-PAMED4U (855-726-3348) or email us at KnowledgeCenter@pamedsoc.org.

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