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See a sample rate comparisonHCPCS B4100 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
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 | View Medicaid rates for B4100 |
National average reimbursement for HCPCS B4100 by major payers:
$7.16
$1.10
$0.45
$1.20
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HCPCS B4100
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See a sample payer proposalHCPCS B4100 vs. Other Enteral Formulas and Additives Codes
The HCPCS B4100 code is part of the Enteral and Parenteral Therapy services used for Enteral Formulas and Additives. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS B4100 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| 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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