In reference to the Pharmacy question of 1-25-16, a recommendation is made to add the modifier JE to the HCPCS J1443 for payment under ESRD PPS. Is that modifier specific to ESRD facilities, or are hospitals expected to report it as well?


According to MLN Matters Number MM9367 (issued December 15, 2015), modifier JE (administered via dialysate) is intended for end-stage renal disease (ESRD) facilities submitting claims to Medicare administrative contractors (MACs) for ESRD services provided to Medicare beneficiaries.


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