Billing Codes - The Healthcare Common Procedural Coding System (HCPCS) codes are utilized by Medicare and many state Medicaid programs for billing purposes.
- Medicare Allowable Rates are established by HCPCS codes for Medicare Part B reimbursement.
- NDC-format codes - Nutrition products do have NDC-format codes assigned to them. These codes are not National Drug Codes (NDCs) as our products are not drugs. NDC-format codes are assigned to our products and sometimes used by payors for billing.
In this section, you can find commonly used billing codes for Abbott Nutrition products:
Note: Effective January 1, 2011, Medicare phased in a new competitive bidding program in some specific areas of the country. This program changed the way Medicare pays some suppliers for certain durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS). It also made changes to who can supply these items in certain areas. The reimbursement rates included in this document reflect 2012 Medicare rates that are not impacted by the Competitive Bidding Program. To determine if a beneficiary resides in or travels to a Competitive Bidding Area where the Medicare fee for DMEPOS items may differ, please visit www.medicare.gov or www.dmecompetitivebid.com.
A chart listing the 2012 HCPCS Codes and Medicare Allowable Rates for Abbott Nutrition Enteral Formulas and Devices is attached below.
2012 Rates and Codes.pdfYou can also find HCPCS codes and rates for all nutritional products at the Medicare Pricing, Data Analysis and Coding (PDAC) site:
https://www.dmepdac.com/