Can anyone confirm whether the JZ/JW modifiers are needed on vaccines? I’m aware of the CMS FAQ and the response, see below, but it seems as if it’s only addressing the vaccines listed in section 1861(s)(10), see below, which is influenza, pneumococcal, hep B and COVID-19 stating the modifiers are not required on those vaccines. That makes me think single-dose vial vaccines require a JZ modifier. If it’s your understanding a JZ modifier is not needed, can you share your source?
Thank you in advance.
jw-modifier-faqs.pdf (cms.gov)
The JW and JZ modifiers are not required for vaccines described under section 1861(s)(10) of the Act that are furnished from single-dose containers. Since the influenza, pneumococcal, and COVID–19 vaccines, specified in section 1861(s)(10) of the Act, are often roster billed by mass immunizers, and roster billing cannot accommodate modifiers, it would be impractical to require the JW and JZ modifiers for such vaccines. Such a requirement would likely result in substantial operational issues for mass immunizers and impair patient access to these vaccines.
Social Security Act §1861 (ssa.gov)
(10)(A) pneumococcal vaccine and its administration and, subject to section 4071(b) of the Omnibus Budget Reconciliation Act of 1987[505], influenza vaccine and its administration; and
(B) hepatitis B vaccine and its administration, furnished to an individual who is at high or intermediate risk of contracting hepatitis B (as determined by the Secretary under regulations);
Thank you in advance.
jw-modifier-faqs.pdf (cms.gov)
The JW and JZ modifiers are not required for vaccines described under section 1861(s)(10) of the Act that are furnished from single-dose containers. Since the influenza, pneumococcal, and COVID–19 vaccines, specified in section 1861(s)(10) of the Act, are often roster billed by mass immunizers, and roster billing cannot accommodate modifiers, it would be impractical to require the JW and JZ modifiers for such vaccines. Such a requirement would likely result in substantial operational issues for mass immunizers and impair patient access to these vaccines.
Social Security Act §1861 (ssa.gov)
(10)(A) pneumococcal vaccine and its administration and, subject to section 4071(b) of the Omnibus Budget Reconciliation Act of 1987[505], influenza vaccine and its administration; and
(B) hepatitis B vaccine and its administration, furnished to an individual who is at high or intermediate risk of contracting hepatitis B (as determined by the Secretary under regulations);