Medicare Part B Inflation Rebate Guidance: Use of the 340B Modifier
This revised Product comprises Subregulatory Guidance for all 340B covered entities that submit claims for separately payable Medicare Part B drugs and biologicals through the 340B Program, and its content is based on publically available content within at https://www.congress.gov/117/plaws/publ169/PLAW-117publ169.pdf#page=25. CMS policy or operation subject matter experts also reviewed/cleared this product. This product educates on how to report modifiers “JG” or “TB” on claim lines for drugs acquired through the 340B Program effective January 1, 2024. The Inflation Reduction Act of 2022 establishes a Part B inflation rebate by manufacturers for certain single source drugs and biologicals with prices increasing faster than the rate of inflation. The “JG” or “TB” modifiers allow us to identify units of drugs acquired through the 340B Program to effectively implement the Part B inflation rebate because units of 340B drugs are excluded from the Part B rebates.
Revisions to this Product include following content updates:
• Added information on what modifiers different categories of 340B covered entities should use in CY 2024 and starting January 1, 2025
The previous version of this product is available to the public and currently posted on the CMS website at https://www.cms.gov/files/document/mln4800856-medicare-part-b-inflation-rebate-guidance-use-340b-modifier.pdf.
Final
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: December 14, 2023
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.