JW, JZ: Drug dosing modifiers

Applies to

All plans

Modifier descriptions

Modifier Short description Long description
 JW

Discarded drug not administered

 Drug amount discarded/not administered to any patient
 JZ Zero drug wasted Zero drug amount discarded/not administered to any patient

The JW and JZ modifier policy applies to all drugs separately payable under Medicare Part B that are described as being supplied in a “single-dose” container or “single-use” package based on FDA-approved labeling.

Modifier JW - Drug amount discarded

The JW modifier is used to identify discarded doses or quantities of the drug or biological from a single-use vial or single-use packaging. We’ve adopted the CMS guideline requiring JW be appended to obtain payment for the discarded amounts effective January 1, 2017. Dosage or quantity reported as waste should be discarded and not administered to another member with documentation in the medical record to support. 

Units reported must correspond with the smallest dose (vial) available from drug manufacturer or pharmacy for purchase. This allows for minimal waste or discarded drug or biological.

Modifier JZ - Zero drug amount discarded

The JZ modifier is used to identify that no amount of drug was discarded and eligible for payment. To align with the CMS modifier policy effective July 1, 2023, the JZ modifier is required when there are no discarded amounts.

Incorrect modifier reporting

Modifier JW and/or JZ appended to a claim that is supplied in a multi dose container will deny for inappropriate modifier use.

Appending both modifier JZ and JW to one claim line is not an appropriate modifier combination and will cause the claim line to be denied.

Both modifiers JW and JZ do not apply to drugs that are not separately payable, such as packaged OPPS or ASC drugs, or drugs administered in the FQHC or RHC setting.

Claim examples of JW and JZ modifiers

JW modifier reporting

Report the drug code on two claims lines (see below) 

Claim line 1:

  • HCPCS code for drug given
  • No modifier
  • Number of units given to the patient
  • Calculated submitted price for only the amount of drug given

Claim line 2:

  • HCPCS code for drug wasted
  • JW modifier to indicate waste
  • Number of units wasted
  • Calculated submitted price for only the amount of drug wasted

JZ modifier reporting

To submit claims for a non-discarded drug, submit one complete claim line:

  • HCPCS code for drug given
  • JZ modifier to indicate no waste
  • Number of units given to the patient
  • Calculated submitted price for the amount given

Resources/references

Modifier JW fact sheet (cms.gov)

Modifier JZ fact sheet (cms.gov)

Medicare Claims Processing Manual, Chapter 17 on Drugs and Biologicals (cms.gov)

JW Modifier and JZ Modifier policy FAQs (cms.gov)

MM13056 - New JZ Claims Modifier for Certain Medicare Part B Drugs (cms.gov)