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See a sample rate comparisonHCPCS B4100 Fee Schedule
HCPCS B4100 is classified under Enteral and Parenteral Therapy, in the Enteral Formulas and Additives subgroup.
Food thickener, administered orally, per ounce
| Key Fact | Detail |
|---|---|
| Service Type | Enteral and Parenteral Therapy Enteral Formulas and Additives |
| Complexity Level | Low |
| Medicaid Fee Schedule | $0.725 median of the 6 states in the free preview · View Medicaid rates for B4100 |
National average reimbursement for HCPCS B4100 by major payers:
$7.16
BCBS / Anthem
$1.10
UnitedHealthcare
$0.45
Aetna
$1.20
Cigna
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HCPCS B4100
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See a sample payer proposalHCPCS B4100 vs. Other Enteral Formulas and Additives Codes
The table lists codes related to B4100. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| B4088-HCPCS | Low | Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
| B4100-HCPCS | Low | Food thickener, administered orally, per ounce |
| B4102-HCPCS | Low | Enteral formula, for adults, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS B4100. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the B4100 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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