Modifier JL

The following modifiers are effective April 1, 2023:

JK - Short Descriptor: Drug supply 1 month or less; Long Descriptor: One month supply or less of drug or biological

JL - Short Descriptor: Drug 3-month supply; Long Descriptor: Three-month supply of drug or biological

Important Billing Message to Suppliers: The system updates necessary to implement this provision will be completed by the implementation date of this instruction. In order to ensure Medicare beneficiaries are not charged more than the $35 maximum allowed for the month of July, suppliers shall not bill for supplies of insulin for July or subsequent months before July 1, 2023.

If the from date of service is in May or June 2023, suppliers must only bill a one-month supply and append the JK modifier. If the JL modifier is billed with a date of service of May or June the claim will be returned as un-processable. For the transition into July implementation, suppliers must wait to bill the supply for July until on or after July 1, 2023 or the claim will be returned as un-processable.

 

Last Updated Feb 21 , 2023