Enteral feeding supply daily allowances billing
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This policy governs billing and authorization for enteral feeding supply daily allowances (HCPCS B4034, B4035, B4036) for Alaska Medicaid and affects durable medical equipment/medical supplies providers billing for enteral nutrition supplies.
New service authorization requests for enteral supplies requested under miscellaneous code B9998 will be denied as unbundling.
Only one unit of service may be billed per day for codes B4034, B4035, or B4036 which cover all supplies (except feeding tube and nutrients) required for one day.
Enteral Supply Coverage Rules
Enteral supply coverage criteria
Coverage and billing rules for enteral feeding supplies:
ALL of the following
Prohibited billing practices
- Separate billing for any daily enteral supply item using an individual HCPCS code when a specific code exists is not allowed (treated as unbundling).
- Existing service authorizations billed as B9998 will be ended for dates of service on or after March 1, 2020.
HCPCS Codes and Unit Limits
| B9998 | Miscellaneous enteral supply code (use prohibited when specific code available) |
Authorization and Billing Requirements
Do not request authorization or bill enteral supplies using B9998 — requests will be denied and prior B9998 approvals ended
New authorization requests for enteral supplies billed under miscellaneous code B9998 will be denied as unbundling; existing service authorizations that list daily usage supplies as units of B9998 will be ended for all dates of service on or after March 1, 2020. Providers must instead bill the appropriate daily supply allowance codes B4034, B4035, or B4036 when seeking reimbursement for enteral supplies.
Key Definitions
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