Coding systems and reimbursement allowable rates for nutritional products and devices vary by payer:

1. Medicare Part B uses HCPCS (Healthcare Common Procedure Coding System), grouping products into payment categories. These categories and their allowable rates are listed in the table below by product.
2. Medicaid programs vary by state, some using HCPCS, some using NDC* format codes, and some using unique local coding systems of their own. Reimbursement rates also vary by state. Individual state details can be found on this site by going back to the Medicaid Policy section and clicking on the appropriate state.
3. Private health insurance and managed care companies may use HCPCS, NDC* format codes, or their own local coding systems. Reimbursement rates vary by company and patient plan.
4. Using the modifier "BO" added to the end of the HCPCS indicates orally administered nutrition, not administered by feeding tube.

*Abbott Nutrition does not represent these codes to be actual National Drug Codes (NDCs). NDC format codes are product codes adjusted according to standard industry practice to meet the format requirements of pharmacy and health insurance computer systems.

NOTE: Information contained in this section is taken from a variety of sources including, but not limited to, official government documents. Such information is provided for our customers from information correct at the time of publication. Abbott Nutrition and Abbott Laboratories assume no responsibility for omissions, errors, or policy changes contained therein. Additionally, the information provided is meant to be a guide for your information only. Each health care provider office is ultimately responsible for verifying codes, coverage, and payment policies used for individual patients to ensure that they are accurate and appropriate for the services and items provided.