Wednesday, August 11, 2010

Medicare CPT B4157 -Enteral and Parenteral Therapy

What is a B- Code ?

B-Codes: relate to Enteral and Parenteral Therapy, including codes for supplies, formulae, nutritional solutions and infusion pumps.

Please note:
Reimbursement Codes.com contains information for enteral nutrition products only.




Reimb Code Description Effective Date Code Price Code Price-5%
B4157 Enteral formula, nutritionally complete, for special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbs, vits and mins, may include fiber, admin through an enteral feeding tube, 100 cal = 1 unit (Effective 2/1/07 Code Price is per 100 calories and is based on median pricing methodology - previously Code Price was based on 1 gm and average pricing methodology) 10/01/09 $3.71 $3.52
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Medicare physician fee schedule - Quick overview

Medicare Part B pays for physician services based on the PFS, which lists the more than 7,400 unique
covered services and their payment rates. Physicians’ services include the following:

* Office visits;
* Surgical procedures;
* Anesthesia services; and
* A range of other diagnostic and therapeutic services.


Medicare Physician Fee Schedule Payment Rates

Payment rates for an individual service are based on
three components:
1) Relative Value Units (RVU)
2) Conversion Factor (CF)
3) Geographic Practice Cost Indices (GPCI)


Medicare Physician Fee Schedule Payment Rates Formula


The Medicare PFS payment rates formula is shown below:

[(Work RVU x Work GPCI) + (PE RVU x PE GPCI) +
(MP RVU x MP GPCI)] x CF

Medicare fee schedule download