J3 Modifier
Competitive acquisition program (cap), drug not available through cap as written, reimbursed under average sales price methodology
HCPCS modifierJ3
- Description
- Competitive acquisition program (cap), drug not available through cap as written, reimbursed under average sales price methodology
- Short description
- Cap drug unavail thru cap
- Added
- January 1, 2006
- Last change
- January 1, 2006
What does the J3 modifier mean?
The HCPCS Level II modifier J3 means: “Competitive acquisition program (cap), drug not available through cap as written, reimbursed under average sales price methodology”. Append it to a HCPCS or CPT code on the claim line when the payer’s policy calls for it; placement and payment effects are defined by each payer.
Other J modifiers
- J1 – Competitive acquisition program no-pay submission for a prescription number
- J2 – Competitive acquisition program, restocking of emergency drugs after emergency administration
- J4 – Dmepos item subject to dmepos competitive bidding program that is furnished by a hospital upon discharge
- J5 – Off-the-shelf orthotic subject to dmepos competitive bidding program that is furnished as part of a physical therapist or occupational therapist professional service
- JA – Administered intravenously
- JB – Administered subcutaneously
- JC – Skin substitute used as a graft
- JD – Skin substitute not used as a graft
- JE – Administered via dialysate
- JK – One month supply or less of drug or biological
- JL – Three month supply of drug or biological
- JW – Drug amount discarded/not administered to any patient
- JZ – Zero drug amount discarded/not administered to any patient