340B Drug Pricing
340B Drug Pricing Program
HRSA-administered drug-discount program that lets eligible safety-net providers buy outpatient drugs at reduced prices.
1 min read · Last reviewed May 23, 2026
At a glance
- Category
- Billing
- Acronym for
- 340B Drug Pricing Program
- Primary sources
- 1
- Workspace handoff
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Where this comes up
This shows up in revenue-cycle work — claim scrubbing, charge entry, posting, A/R follow-up, and month-end close. Billers and practice managers hit this term when reconciling a payment, working a denial queue, or auditing why a claim aged past 60 days.
Full definition
What it is in practice
HRSA 340B covers covered entities including FQHCs, RHCs, and disproportionate-share hospitals. The program has strict eligibility, patient-definition, and audit requirements.
How it shows up in your practice
340B billing on Medicare claims requires modifier JG (or TB for some payers). Track 340B-eligible patients, drugs, and audit trails meticulously.
Sources
- HRSA — 340B Drug Pricing Programhttps://www.hrsa.gov/opa
Look up 340B rules in Ask D3
Open ask d3 →Related terms
- TelehealthFQHC (Federally Qualified Health Center)A community-based safety-net provider that meets requirements at section 1861(aa) of the Social Security Act and receives prospective payment from Medicare and enhanced reimbursement from Medicaid.
- TelehealthRural Health ClinicA federally certified clinic in an underserved rural area that bills Medicare under a special all-inclusive rate methodology.
- BillingJ-CodeHCPCS Level II codes (J0000-J9999) used to bill drugs administered other than by oral method.
- BillingNDC (National Drug Code)FDA-assigned 10-digit identifier for FDA-approved drugs and biologics.
D3rx is a healthcare-billing and compliance research aid maintained by D3rx Inc. Articles are drafted by an LLM (Anthropic Claude) against primary HHS, OCR, CMS, eCFR, NIST, and state-regulator publications, and reviewed for restraint and source fidelity by the D3rx team.
Reviewer status: a named credentialed reviewer (CHC, CHPC, or healthcare attorney) is being engaged. Until that engagement is finalized, this page does not claim credentialed review.
Related across the archive
- GlossaryJ-CodeHCPCS Level II codes (J0000-J9999) used to bill drugs administered other than by oral method.
- GlossaryNDC (National Drug Code)FDA-assigned 10-digit identifier for FDA-approved drugs and biologics.
- GlossaryFQHC (Federally Qualified Health Center)A community-based safety-net provider that meets requirements at section 1861(aa) of the Social Security Act and receives prospective payment from Medicare and enhanced reimbursement from Medicaid.
- GlossaryRural Health ClinicA federally certified clinic in an underserved rural area that bills Medicare under a special all-inclusive rate methodology.
- GlossarySliding Fee Discount ScaleA discount schedule based on family income and size, required of HRSA-funded health centers for patients at or below 200% of FPL.
- BillingAWV + Problem Visit Same Day: How to Bill CorrectlyYes, you can bill AWV and a problem visit the same day. Here's how to do it correctly with modifier -25.
- BillingPlace of Service Codes: Which One to Use and Why It Changes Your ReimbursementPOS 11 vs 21 vs 02 vs 10. How the two-digit code on your claim determines whether you get office or facility rates.
- BillingUB-04 Billing: Bill Types, Revenue Codes, and Occurrence Codes ExplainedBill type 111 vs 131, revenue code 0250, occurrence span code 70. Every UB-04 field explained in plain English.
This glossary entry is a research aid for billing and compliance staff. It does not provide legal, medical, or financial advice and does not replace counsel. References cited link to primary sources at HHS, OCR, CMS, eCFR, NIST, and the relevant payer or industry body.