CMS Delays Requirement for “JW” Billing Modifier for Outpatient Drug Wastage

July 11, 2016

The Centers for Medicare & Medicaid Services (CMS) has delayed until January 1, 2017 a requirement that Medicare Part B providers bill the unused portion of a single use vial as a separate expense line with a “JW’ modifier. A copy of the revised notice from Noridian is here.

The purpose of the requirement is to enable Medicare Administrative Contractors and CMS to monitor and ensure providers are using appropriate combinations of single-use vials to minimize drug wastage. The effective date of the new billing requirement was originally scheduled for July 1, 2016. The American Hospital Association and other provider groups advocated for the delay, citing the significant changes to billing systems necessary to accommodate the new billing requirement.  (Andrew Busz,andrewb@wsha.org)

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