← Back to list
340B Drug Program Billing Policy Changes
Act
by Dec 1, 2025
Effective date
Dec 1, 2025
Identified
Jun 18, 2026
Summary
Starting December 1, 2025, South Carolina providers purchasing drugs through the 340B program must include the 'TB' modifier on all Medicaid fee-for-service claims and ensure their billing numbers are on the HRSA Medicaid Exclusion file. The TB modifier must be in the second position on UB-04 claims with multiple modifiers.
Get alerts when payers change rules like this one
We check SC Medicaid - SCDHHS and other payers every day and email you when a change matches your specialty and state.
Get SC Medicaid - SCDHHS alertsPolicy Monitoring is free. No card required.
What to do
by Dec 1, 2025 · 5 steps
01Billing team must update billing systems to automatically include 'TB' modifier on all 340B drug claims for South Carolina Medicaid fee-for-service patients.
02Ensure TB modifier appears in second position on UB-04 claims with multiple modifiers.
03Verify provider's NPI and state billing numbers are listed on HRSA Medicaid Exclusion file.
04Confirm billed amounts do not exceed actual acquisition costs.
05Contact Provider Service Center at (888) 289-0709 with questions.
Original notice
340B Drug Program Billing Policy Changes
scdhhs.gov · Always check the source before changing claims.