We’re introducing a streamlined Point32Health Drugs and Biologicals Payment Policy, effective for dates of service beginning Nov. 1, 2024, which will replace — and consolidate the pertinent information from — the current Tufts Health Plan Drugs and Biologicals Payment Policy, as well as Harvard Pilgrim’s Injectable and Implantable Outpatient Drugs and Drug Wastage Payment Policies.
As of the Nov. 1 effective date, for all products, Point32Health will require providers to append modifier JW or JZ when reporting a drug from a single-dose vial or package. This requirement is currently in place for Tufts Medicare Preferred and Tufts Health Plan Senior Care Options, but will be extended to include Harvard Pilgrim Health Care Commercial, Tufts Health Plan Commercial, and Tufts Health Public Plans.
As a reminder, modifier JW should be reported when there is drug waste from a single-dose vial or package, while modifier JZ should be reported when there is no drug waste.
For more information, please refer to the new Point32Health Drugs and Biologicals Payment Policy.