Reimbursement Code Information

  • Reimbursement Rates and Codes for Medicare Part B

    When using this information, please note the following: Coding systems and reimbursement allowable rates vary by payer.

    • Medicare Part B uses HCPCS (Healthcare Common Procedure Coding System) to group products.

    • Medicaid systems vary by state; some use HCPCS while others use Product Reimbursement Codes or systems of their own. Contact your state provider for more information.

    • Private health insurance and managed care companies may use HCPCS, Product Reimbursement Codes, or their own system. Contact your provider for more information.

Metabolic / Diet Modifiers
  • BCAD 1
    • Item #: 892801
      Description: Powder
      Unit Size: 1 lb can
      Cal./Unit: 2280
      Prod. Yield / Unit (fl oz): Varies
      Case: 6 cans per case
      HCPCS Code: B4162
      Reimbursement Code: 0087-510184

  • BCAD 2
    • Item #: 891501
      Description: Powder
      Unit Size: 1 lb can
      Cal./Unit: 1860
      Prod. Yield / Unit (fl oz): Varies
      Case: 6 cans per case
      HCPCS Code: B4162
      Reimbursement Code: N/A

  • GA
    • Item #: 892901
      Description: Powder
      Unit Size: 1 lb can
      Cal./Unit: 2280
      Prod. Yield / Unit (fl oz): Varies
      Case: 6 cans per case
      HCPCS Code: B4157 or B4162
      Reimbursement Code: 0087-510188

  • HCY 1
    • Item #: 893301
      Description: Powder
      Unit Size: 1 lb can
      Cal./Unit: 2280
      Prod. Yield / Unit (fl oz): Varies
      Case: 6 cans per case
      HCPCS Code: B4162
      Reimbursement Code: 0087-510202

  • HCY 2
    • Item #: 891901
      Description: Powder
      Unit Size: 1 lb can
      Cal./Unit: 1860
      Prod. Yield / Unit (fl oz): Varies
      Case: 6 cans per case
      HCPCS Code: B4157 or B4162
      Reimbursement Code: N/A

  • LMD
    • Item #: 893101
      Description: Powder
      Unit Size: 1 lb can
      Cal./Unit: 2280
      Prod. Yield / Unit (fl oz): Varies
      Case: 6 cans per case
      HCPCS Code: B4157 or B4162
      Reimbursement Code: 0087-510196

  • OA 1
    • Item #: 893201
      Description: Powder
      Unit Size: 1 lb can
      Cal./Unit: 2280
      Prod. Yield / Unit (fl oz): Varies
      Case: 6 cans per case
      HCPCS Code: B4162
      Reimbursement Code: 0087-510199

  • OA 2
    • Item #: 891701
      Description: Powder
      Unit Size: 1 lb can
      Cal./Unit: 1860
      Prod. Yield / Unit (fl oz): Varies
      Case: 6 cans per case
      HCPCS Code: B4157 or B4162
      Reimbursement Code: N/A

  • PFD Toddler
    • Item #: 892701
      Description: Powder
      Unit Size: 1 lb can
      Cal./Unit: 2410
      Prod. Yield / Unit (fl oz): Varies
      Case: 6 cans per case
      HCPCS Code: B4155
      Reimbursement Code: 0087-510178

  • PFD 2
    • Item #: 891601
      Description: Powder
      Unit Size: 1 lb can
      Cal./Unit: 1820
      Prod. Yield / Unit (fl oz): Varies
      Case: 6 cans per case
      HCPCS Code: B4155
      Reimbursement Code: N/A

  • Phenyl-Free® 1
    • Item #: 892601
      Description: Powder
      Unit Size: 1 lb can
      Cal./Unit: 2280
      Prod. Yield / Unit (fl oz): Varies
      Case: 6 cans per case
      HCPCS Code: B4162
      Reimbursement Code: 0087-510172

  • Phenyl-Free® 2
    • Item #: 891301
      Description: Powder
      Unit Size: 1 lb can
      Cal./Unit: 1860
      Prod. Yield / Unit (fl oz): Varies
      Case: 6 cans per case
      HCPCS Code: B4162
      Reimbursement Code: N/A

  • Phenyl-Free® 2 HP
    • Item #: 891401
      Description: Powder
      Unit Size: 1 lb can
      Cal./Unit: 1770
      Prod. Yield / Unit (fl oz): Varies
      Case: 6 cans per case
      HCPCS Code: B4157 or B4162
      Reimbursement Code: N/A

  • TYROS 1
    • Item #: 893001
      Description: Powder
      Unit Size: 1 lb can
      Cal./Unit: 2280
      Prod. Yield / Unit (fl oz): Varies
      Case: 6 cans per case
      HCPCS Code: B4162
      Reimbursement Code: 0087-510191

  • TYROS 2
    • Item #: 891801
      Description: Powder
      Unit Size: 1 lb can
      Cal./Unit: 1860
      Prod. Yield / Unit (fl oz): Varies
      Case: 6 cans per case
      HCPCS Code: B4162
      Reimbursement Code: N/A

  • WND® 1
    • Item #: 893401
      Description: Powder
      Unit Size: 1 lb can
      Cal./Unit: 2270
      Prod. Yield / Unit (fl oz): Varies
      Case: 6 cans per case
      HCPCS Code: B4162
      Reimbursement Code: 0087-510205

  • WND® 2
    • Item #: 892001
      Description: Powder
      Unit Size: 1 lb can
      Cal./Unit: 1860
      Prod. Yield / Unit (fl oz): Varies
      Case: 6 cans per case
      HCPCS Code: B4157 or B4162
      Reimbursement Code: N/A