MedicaidBilling CodesMedium impact
25-1007m Maximize Savings with the Federal 340B Drug Pricing Program
Health Net·CA·Pharmacy
We identified it
Jun 20, 2026
Summary
Health Net updated requirements for 340B drug pricing program claims to prevent duplicate discounts. Providers must use modifier UD for physician-administered drugs and code '08' in the Basis of Cost Determination field for pharmacy claims when using 340B-purchased drugs for Medi-Cal beneficiaries.
Action Required
Immediately: Billing team must update claim submission processes to include modifier UD for all physician-administered drugs purchased through 340B program for Medi-Cal patients. Pharmacy staff must use '08' in Basis of Cost Determination field for 340B pharmacy claims. Update billing software rules and train staff on proper 340B claim identification to ensure compliance with federal duplicate discount prevention requirements.