CMS Pub. 100-04, ch. 17, § 100.2.5

The restocking modifier is: J2 - Competitive Acquisition Program, (CAP) restocking of

emergency drugs after emergency administration.

Under certain circumstances, physicians will be permitted to administer a drug they have

on hand and go through the CAP program to restock it. Once the participating CAP

physician orders and receives the restocking drug from the approved CAP vendor, the

physician will bill for the administration fee. The physician will also include no-pay

lines on the claim for each of the drugs as usual. These lines will include the restocking

modifier in addition to the no-pay modifier (in the first modifier position), the procedure

code for the drug, the prescription number and all other elements normally required.

A/B MACs (B) shall consider “restocking” drug claims for payment when the following

requirements are met:

a) The physician has elected to receive the drug under CAP;

b) The physician has submitted the claim with the “restocking” modifier;

c) The physician received the drug from the CAP vendor to replace a drug he or she

used from pre-existing stock.

d) The claim was submitted with the “restocking” modifier:

J2 - Competitive Acquisition Program, (CAP) restocking of emergency drugs after

emergency administration.

By including the “restocking” modifier on the claim, the physician is asserting that:

a) The drug was required immediately;

b) The need couldn’t be anticipated;

d) The drug was administered in an emergency situation; and

e) Documentation is being maintained in the file to validate the information in a - d and

will be made available to the A/B MAC (B) at their request.