Modifier JZ: Zero Drug Wasted Attestation
The JZ modifier attests that no drug was discarded from a single-dose container. Who must use JZ, how it differs from JW, and claim returns without it.
Modifier JZ is a HCPCS Level II modifier that attests no amount of a drug from a single-dose container or single-use package was discarded. CMS's descriptor is "Zero drug amount discarded/not administered to any patient." Medicare has required it since July 1, 2023 on every separately payable Part B drug line from a single-dose container that has no waste (Pub. 100-04, ch. 17, §40).
Key takeaways
- JZ goes on the drug line, with the administered units, when nothing was discarded.
- When something was discarded, bill the dose with no modifier and the waste on a second line with JW. JZ and JW never share a line.
- JZ also applies when the whole vial fits in one billing unit, even if a little was thrown away.
- Since October 1, 2023, single-dose drug claims without the right modifier may be returned as unprocessable.
- JZ doesn't change payment. It is an attestation CMS uses to calculate manufacturer refunds.
Modifier JZ · payment effect
With and without the modifier
96413 without JZ · national office
$133.27
Chemo IV infusion
96413-JZ · No change to the rate
$133.27
Attests no drug was discarded from a single-dose container. No payment change.
When to use the JZ modifier
Use JZ on the drug's claim line when:
- The drug is separately payable under Medicare Part B (for example, an infused biologic given with 96413 or an injection given with 96372).
- It comes from a single-dose container or single-use package under FDA labeling. CMS publishes the list of HCPCS codes that may require JW or JZ.
- None of the container was discarded: the prescribed dose used the full labeled amount.
- Or the dose was smaller than one billing unit and the leftover fits inside that unit. CMS doesn't pay fractional units, so you bill the full unit with JZ and no JW line (FAQ, Q11).
The line carries the drug code, JZ and the administered units. CMS says the JZ line doesn't have to account for whole vials.
Suppliers that don't administer the drug report JZ when nothing was discarded during preparation, and JW when something was (ch. 17, §40).
When not to use the JZ modifier
- Multiple-dose vials. Neither JZ nor JW applies.
- Drugs that aren't separately payable: packaged OPPS or ASC drugs, and drugs given in an FQHC or RHC.
- Vaccines paid under §1861(s)(10) of the Act, which are often roster billed.
- Incident-to supplies. Since January 1, 2026, non-BLA skin substitutes are paid as supplies under the PFS, and CMS says JZ is not appropriate for them.
- Any line that also reports waste. That waste goes on a JW line, and the dose line carries no modifier.
How JZ affects payment
JZ has no payment effect. The drug line is paid at its Part B drug rate for the administered units, and the administration code is paid from the physician fee schedule as usual. The modifier exists for data: CMS uses JZ and JW reporting to calculate refunds that manufacturers of refundable single-dose drugs owe for discarded amounts under the Infrastructure Investment and Jobs Act.
JZ vs JW
| JZ | JW | |
|---|---|---|
| Meaning | Nothing discarded | Discarded amount on this line |
| Lines for the drug | One | Two (dose with no modifier, waste with JW) |
| Units on the modifier line | Administered units | Discarded units |
| Required since | July 1, 2023 | January 1, 2017 |
| Payment effect | None | Pays for the discarded units |
FAQ
What's the difference between JZ and JW modifiers?
JZ attests that nothing was discarded and goes on the dose line. JW reports discarded units on a separate line so Medicare pays for them. Use one or the other for a single-dose-container drug.
Can modifiers JW and JZ be billed together?
Not for the same dose. If there's waste, the dose line has no modifier and the waste line has JW. If there's no waste, the single line has JZ.
Is the JZ modifier only for Medicare?
It is a traditional Medicare Part B requirement. Medicare Advantage plans, Medicaid programs and commercial payers decide for themselves whether to require it.
What J-codes require a JZ modifier?
Any separately payable Part B drug code billed from a single-dose container or single-use package, when nothing is discarded. CMS publishes a list of codes that may require JW or JZ; the container on hand decides it, so check the label.
Why do we use the JZ modifier?
So CMS can tell a claim with no waste from a claim that simply left the waste unreported. That data is how CMS calculates manufacturers' discarded-drug refunds.
Keep reading
- Modifier JW for billing discarded amounts.
- Modifier GA when a drug may fail medical necessity.
- Codes on this page: 96413 96372 96365
Sources: CMS Medicare Claims Processing Manual, Pub. 100-04, ch. 17, §40 (Rev. 13108); CMS Discarded Drugs and Biologicals: JW and JZ Modifier Policy FAQs (Q5, Q10–Q13, skin substitutes). Verified October 6, 2026.
