Dear Aetna Better Health of Ohio Provider,
The Ohio Department of Medicaid (ODM) implemented the use of the SE modifier to signify when a 340B entity has used a 340B drug for outpatient services. This policy was effective January 1, 2018. Aetna Better Health of Ohio has updated our system to accept these modifiers for claims.
In the past, ODM has excluded all drugs reported by providers who were on the Health Resources Services Administration's (HRSA) 340B Medicaid Exclusion File (MEF). By implementing the SE modifier, ODM will be able to distinguish when a 340B drug was used in an outpatient setting.
340B entities are required to report the SE modifier when a 340B drug is used for outpatient services as follows:
Revenue Center Code 25X reported with a J- or Q- pharmaceutical code.
Revenue Center Code 636 reported with a J- or Q- pharmaceutical code.
Should you have any questions related to this update, please contact Provider Services at 1-855-364-0974.