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See a sample rate comparisonHCPCS B4104 Fee Schedule
HCPCS B4104 is classified under Enteral and Parenteral Therapy, in the Enteral Formulas and Additives subgroup.
Additive for enteral formula (e.g., fiber)
| Key Fact | Detail |
|---|---|
| Service Type | Enteral and Parenteral Therapy Enteral Formulas and Additives |
| Complexity Level | Low |
| Medicaid Fee Schedule | $0.675 median of the 2 states in the free preview · View Medicaid rates for B4104 |
National average reimbursement for HCPCS B4104 by major payers:
$7.50
BCBS / Anthem
$0.20
UnitedHealthcare
$0.13
Aetna
$1.01
Cigna
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HCPCS B4104
5 of 8 sample ratesHigher to lower in this preview
Aztec Urgent Care, LLC
Aztec Urgent Care LLC
$0.07Published rateBorbas Surgical Supply, Inc
Borbas Surgical Supply Inc
$0.05Published rateBorbas Surgical Supply, Inc
Borbas Surgical Supply Inc
$0.05Published rateBorbas Surgical Supply, Inc
Borbas Surgical Supply Inc
$0.01Published rateBorbas Surgical Supply, Inc
Borbas Surgical Supply Inc
$0.01Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS B4104 vs. Other Enteral Formulas and Additives Codes
The table lists codes related to B4104. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| B4103-HCPCS | Low | Enteral formula, for pediatrics, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit |
| B4104-HCPCS | Low | Additive for enteral formula (e.g., fiber) |
| B4105-HCPCS | Low | In-line cartridge containing digestive enzyme(s) for enteral feeding, each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS B4104. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the B4104 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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