Attention Be Healthy Providers: Clarification for 340B Covered Entities on Requirement to Submit a UD Modifier on claims for HNE Be Healthy (MassHealth) Providers.
Posted on January 30, 2013
As posted on January 3rd, MassHealth Managed Care Organizations (MCO) are required to collect National Drug Code (NDC) information on claims for drugs administered as part of an outpatient visit as required by the Affordable Care Act.
Entities participating in the 340B program are exempted from this requirement and do not need to submit NDC codes for drug claims.
However, all 340B covered entities must add the modifier “UD” with the HCPCS code to indicate that the drug was purchased through the 340B program. Submitting the “UD” modifier will enable HNE to ensure that your claims are not denied for failure to submit the NDC code. The “UD” modifier will serve as a flag to allow your claims through the system.
If you have any questions, please contact HNE’s Provider Relations staff at 413.233.3313 or 800.842.4464, extension 5000.
We appreciate your assistance in helping us meet the requirements of the Affordable Care Act.
