As of April 2021, Medicare requires the use of the JA or JB modifier when billing for drugs that have one Healthcare Common Procedure Coding System Level II (J or Q) code but multiple routes of administration.
Articles tagged with "self-administration"
The ACR, CSRO and Arthritis Foundation asked the Centers for Medicare & Medicaid Services to review the decision to add Stelara to the Self-Administered Drugs list, which would limit access for patients who can’t self-administer.
UnitedHealthcare (UHC) is rescinding changes to its Orencia policy previously scheduled to go into effect July 1, 2020. These changes would have required patients to fail to respond to the self-administered formulation of the drug prior to obtaining authorization for the physician-administered product. Some patients on Orencia received notices from UHC in late April stating…