MedicaidBilling CodesMedium impact
23-1207 Lower Pricing Available to Providers Through 340B Federal Drug Discount Program
Health Net·CA·Prior Authorization
We identified it
Jun 20, 2026
Summary
Health Net CalViva Health now allows providers participating in the 340B Federal Drug Discount Program to access lower drug pricing by using modifier UD08 on claims. Providers must properly identify 340B purchased drugs on claims using UD modifier for physician-administered drugs and 08 in the Basis of Cost Determination field for pharmacy claims to prevent duplicate discounts.
Action Required
Immediately: Eligible 340B providers must update billing procedures to include UD modifier on physician-administered drug claims and code 08 in Basis of Cost Determination field for pharmacy claims when 340B purchased drugs are used. Billing team should verify 340B eligibility status and train staff on proper modifier usage to access discounted pricing and prevent duplicate discount violations.