MedicaidBilling CodesHigh impact
Provider Letter 2022-16: Re: 340B Drug Discount Program Rule Changes
Oklahoma SoonerCare·OK·Pharmacy
Effective date
Sep 12, 2022
We identified it
Jun 20, 2026
Summary
SoonerCare (Oklahoma Medicaid) now requires 340B providers to use specific modifiers when billing outpatient drugs to distinguish between 340B purchased drugs (modifiers JG or TB) and non-340B purchased drugs (modifier UD). Claims without the appropriate modifiers will be denied.
Action Required
By September 12, 2022: 340B providers must update billing systems to automatically append modifier JG or TB for all 340B purchased drugs and modifier UD for all non-340B purchased drugs on outpatient/hospital claims. Billing team must train staff on proper modifier usage and update claim submission workflows. Failure to include appropriate modifiers will result in automatic claim line denials for covered outpatient drugs.