MedicaidReimbursementMedium impact
$12 Dispensing Fee for 340B Purchased Drugs
Illinois Medicaid - HFS·IL · Pharmacy, Oncology, Nephrology·Provider Notice
Effective date
Feb 1, 2013
We identified it
Jun 20, 2026
Summary
Illinois Medicaid will pay a $12 dispensing fee for generic and brand name drugs purchased under the federal 340B drug pricing program, effective February 1, 2013. Providers must use specific modifier codes (UD for non-pharmacy providers, Submission Clarification Code 20 for pharmacy providers) to identify 340B drugs and can add the $12 fee to their actual acquisition cost.
Action Required
Immediately for claims from February 1, 2013 forward: Pharmacy providers must populate Submission Clarification Code (42Ø-DK) field with value 20 for 340B drugs and add $12 dispensing fee to provider charge. Non-pharmacy providers must report modifier 'UD' with appropriate procedure codes on HFS 2360, HIPAA 837 Professional, UB-04, or HIPAA 837 Institutional forms and add $12 dispensing fee to actual acquisition cost. Void and re-bill any 340B drug claims from February 1, 2013 onward that were submitted without the dispensing fee.