Enteral Billing

Billing Enteral Nutrition:

Number of Calories Prescribed ÷ 100 x Number of Days Billed = Number of Units

Example: Prescribed calories: 1500 per day for 30 days (one month), so 1500 Calories ÷ 100 x 30 Days = 450 Units for the month

If a physician orders more than one nutrient in the same category, the charges must be combined with the caloric units for these nutrients on one line. Each nutrien…t and the calories per day must be listed separately on the certification form.

Example: The certification indicates Osmolite at 750 calories per day and Ensure at 750 calories per day. Both nutrients are in the same category and should be coded as B4150, combined and submitted as follows: 1500 calories ÷ 100 x 30 Days = 450 Units for the month

Our Summary: Medicare will reimburse only for the number of calories ordered by the physician, divided by 100 and multiplied by the number of days supplied. Medicare will not reimburse for partial cans of unused product.

Information found on TeamDME website