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Reminder-340B Drug Program Billing Policy Change
Act
by Apr 1, 2026
Effective date
Apr 1, 2026
Identified
Jun 18, 2026
Summary
Starting April 1, 2026, South Carolina Medicaid providers who purchase drugs through the 340B program must append the 'TB' modifier to all drug claims and ensure charges don't exceed net acquisition costs for primary Medicaid claims.
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What to do
by Apr 1, 2026 · 4 steps
01Billing team must update system to automatically append 'TB' modifier to all 340B drug claims for South Carolina Medicaid members in outpatient settings.
02Configure billing rules to ensure charges don't exceed net acquisition costs when Medicaid is primary payer.
03On UB-04 claims with multiple modifiers, ensure TB modifier appears in second position.
04Update encounter forms and staff training for 340B drug billing procedures.
Original notice
Reminder-340B Drug Program Billing Policy Change
scdhhs.gov · Always check the source before changing claims.