Supporting efficient care delivery: We work closely with providers to reduce administrative burden and improve workflow efficiency.

Improving patient outcomes: Through coordinated utilization management, eligibility support, and clinical collaboration.

Ensuring compliance and integrity: We uphold regulatory standards while offering confidential reporting and compliance support.

Q: Is the TB modifier required on claims for 340B-acquired drugs?

A: Yes. Effective immediately, all claims for eligible 340B-acquired drugs must include the required TB modifier, consistent with applicable CMS billing requirements.

Claims submitted without the required TB modifier may be rejected or denied as incomplete and will require correction and resubmission before processing.

Providers are responsible for ensuring that claims are submitted with all required modifiers and billing information. Failure to include the required TB modifier, when applicable, may result in delays in payment.

Questions? Contact Provider Services at pnm@imperialhealthholdings.com.