MedicaidAdministrativeMedium impact
Basis of Cost Determination Field Required for Drugs Purchased Under the 340B Discount Program
Maryland Medicaid·MD · Oncology, Infectious Disease, Hematology +1 more·Provider Transmittal
We identified it
Jun 20, 2026
Summary
Maryland Medicaid now requires providers to complete a 'Basis of Cost Determination' field when billing for drugs purchased under the 340B discount program. This field must specify how the drug cost was calculated and is mandatory for all 340B drug claims.
Action Required
Immediately: Billing team must update all drug claims for 340B purchased medications to include the 'Basis of Cost Determination' field in billing submissions. This field must specify the methodology used to calculate drug costs (such as acquisition cost, AWP, or other pricing basis). Update billing software templates and train staff on proper completion. Claims for 340B drugs without this field may be denied or delayed.