CMS Pub. 100-04, ch. 17, § 100.2.6

The “furnish as written” modifier is: J3 - Competitive Acquisition Program, (CAP) drug

not available through CAP as written, reimbursed under average sales price methodology.

When the J3 modifier is used, the physician will be allowed to bill Medicare for a CAP

drug in addition to the claim for the administration of that drug.

A/B MACs (B) shall consider “furnish as written” drug administration claims for

payment outside of the CAP program when the new “furnish as written” modifier is used.

By using only the J3 modifier on the claim, the physician is asserting that:

a) A specific drug product was medically necessary;

b) The selected drug vendor could not provide that specific brand and/or NDC for the

CAP HCPCS code;

and

c) Documentation is being maintained on file to validate the information in a) and b) and

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