Effective May 1, 2021, UnitedHealthcare Community Plan of New Jersey will deny the claim lines billed with the JW modifier. Claim lines billed with the JW modifier are not covered under New Jersey FamilyCare/Medicaid, as they are only eligible for reimbursement under Medicare Part B.
When submitting a claim, you must bill for the drug amount administered on one line, and on a separate line, report the amount of drug not administered (discarded) with the JW modifier appended to the associated CPT®/HCPCS code.
Review the reimbursement policy
For more information regarding this requirement, please review Medicare Program JW Modifier: Drug/Biological Amount Discarded/Not Administered To Any Patient Frequently Asked Questions available at cms.gov.