Article Detail - JA DME
Competitive Bid Temporary Gap Period Modifier Use
Effective January 1, 2024, and thereafter, a temporary gap period will be in place for the Competitive Bidding Program (CBP). The competitive bid modifiers KV, J4, and J5 will no longer be used. For HCPCS codes L0648, L0650, L1833, and L1851, treating practitioners have the option to undergo the regular prior authorization process with the standard timeframe for review, requesting an expedited review, or utilize the ST modifier to indicate an acute/emergent need. It is important to note that this process change specifically impacts non-contract competitive bid suppliers who are practitioners/physicians, physical therapists, and occupational therapists. For further details, please consult the Timeline and Updates section of the Prior Authorization and Pre-Claim Review Initiatives webpage on the CMS website.
