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    OpenPayerBilling CodesEnteral and Parenteral TherapyHCPCS hcpcs-b4100-food-thickener-oral-per-ounce
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    HCPCS Level II B4100: Food Thickener, Oral, Per Ounce

    HCPCS Level II code B4100 describes a food thickener, administered orally, billed per ounce, used to modify the consistency of liquids and foods for patients with dysphagia or swallowing impairment; the service is a nutrition/consumable supply typically provided in outpatient, home health, long-term care, or inpatient settings when clinicians or speech-language pathologists identify a need for thickened feeds to reduce aspiration risk.

    For related coverage guidance, see recent payer policy updates: Percutaneous Electrical Nerve Field Stimulation for Functional Abdominal Pain Disorders, Esophagogastroduodenoscopy (EGD) Coverage Policy, Radiofrequency Therapy for Fecal Incontinence.

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an older adult with oropharyngeal dysphagia following stroke, neurodegenerative disease (e.g., Parkinson disease), or head and neck cancer treatment who requires thickened oral liquids to reduce aspiration risk. The product billed with B4100 is a commercial powdered or pre-measured food thickener dispensed by a clinic, skilled nursing facility, home health agency, or durable medical supply provider and administered orally by the patient or caregiver. Clinical workflow: the patient receives a swallow evaluation (clinical bedside and often instrumental such as a videofluoroscopic swallow study), a dysphagia treatment plan is documented with recommended liquid viscosity (e.g., nectar, honey, pudding consistency), and the provider orders or dispenses B4100 to achieve the prescribed thickness. Nursing or speech-language pathology documents education on preparation, dosing per ounce, storage, and monitoring for tolerance; supplies are refilled as clinically indicated and billed using B4100 per ounce units for reimbursement.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    92526Evaluation of oral and pharyngeal swallowing function, with interpretation and report (e.g., clinical bedside)Often performed before recommending or dispensing B4100 to determine need for liquid modification.
    92610Evaluation of oral and pharyngeal swallowing function (e.g., videofluoroscopic, with interpretation and report)Instrumental assessment that guides recommended viscosity and supports medical necessity for thickener supplies.
    97150Therapeutic procedures, group (e.g., not more than 4 patients)Used when speech-language pathology conducts group dysphagia therapy where thickener education is included.
    99401Preventive medicine counseling, individual; approximately 15 minutes (behavioral counseling)Counseling and education on safe swallowing and home preparation of thickeners may be billed when documentation supports face-to-face counseling.
    94664Demonstration and/or evaluation of patient utilization of an aerosol medication device (e.g., not directly related)Data not directly related; include only if payer requires linkage for device education—otherwise not typically used with B4100.

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    251B00000X
    364S00000X
    207Q00000X
    207L00000X
    146D00000X
    261QM0855X
    103TM1700X
    1835G0000X

    Related ICD-10-CM Codes

    25 rows

    ICD-10-CM CodeDescription
    E43Unspecified severe protein-calorie malnutrition
    E44.1Mild protein-calorie malnutrition
    E86.0Dehydration
    E86.1Hypovolemia
    F02.80Dementia in other diseases classified elsewhere, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
    F03.90Unspecified dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
    G12.21Amyotrophic lateral sclerosis
    G31.84Mild cognitive impairment of uncertain or unknown etiology
    G91.9Hydrocephalus, unspecified
    J69.0Pneumonitis due to inhalation of food and vomit

    Showing 1–10 of 25

    Related Payer Policy Updates

    Specialty: Gastroenterology1 / 2

    10 rows

    PolicyPayerEffective Date
    Percutaneous Electrical Nerve Field Stimulation for Functional Abdominal Pain Disordersbcbsvermont2026-12-01
    Esophagogastroduodenoscopy (EGD) Coverage Policyevicore2026-11-05
    Radiofrequency Therapy for Fecal IncontinenceCigna2026-10-15
    Magnetic Sphincter Augmentation for the Treatment of Gastroesophageal Reflux Disease (GERD)univerahealthcare2026-10-15
    High-Resolution Anoscopy (HRA)Premera Bluecross2026-10-01
    Gastroesophageal and Gastrointestinal (GI) Services and ProceduresColorado Rocky Mountain Health Plans2026-10-01
    Serum Testing for Hepatic Fibrosis in the Evaluation and Monitoring of Chronic Liver DiseaseOscar Health2026-10-01
    Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant TestingOscar Health2026-10-01
    Pancreatic Enzyme Testing for Acute PancreatitisOscar Health2026-10-01
    Helicobacter pylori TestingOscar Health2026-10-01

    Related Codes

    HCPCS-B4034-ENTERAL-FEEDING-SYRINGE-FED-DAILY-KIT

    HCPCS Level II B4034: Enteral Feeding Supply Kit, Syringe-Fed Per Day

    HCPCS-B4035-ENTERAL-FEEDING-SUPPLY-KIT-PUMP-FED-PER-DAY

    HCPCS Level II B4035: Enteral Feeding Supply Kit, Pump-Fed, Per Day

    HCPCS-B4036-ENTERAL-FEEDING-SUPPLY-KIT-GRAVITY-FED-DAILY

    HCPCS Level II B4036: Enteral Feeding Supply Kit, Gravity-Fed, Per Day

    HCPCS-B4081-NASOGASTRIC-TUBING-WITH-STYLET

    HCPCS Level II B4081: Nasogastric Tubing With Stylet

    HCPCS-B4082-NASOGASTRIC-TUBING-WITHOUT-STYLET

    HCPCS Level II B4082: Nasogastric Tubing Without Stylet

    HCPCS-B4083-LEVINE-STOMACH-TUBE-NASOGASTRIC-SUPPLY

    HCPCS Level II B4083: Levine Stomach Tube

    HCPCS-B4087-GASTROSTOMY-JEJUNOSTOMY-TUBE-STANDARD

    HCPCS Level II B4087: Gastrostomy/Jejunostomy Feeding Tube, Standard

    HCPCS-B4088-LOW-PROFILE-GASTROSTOMY-JEJUNOSTOMY-TUBE

    HCPCS Level II B4088: Low-Profile Gastrostomy/Jejunostomy Tube

    HCPCS-B4102-ENTERAL-FLUID-ELECTROLYTE-REPLACEMENT-FORMULA-ADULT

    HCPCS Level II B4102: Enteral Formula for Fluid and Electrolyte Replacement

    HCPCS-B4103-PEDIATRIC-ENTERAL-FLUID-REPLACEMENT

    HCPCS Level II B4103: Pediatric Enteral Formula for Fluid/Electrolyte Replacement

    Showing 1–10 of 50

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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