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See a sample rate comparisonHCPCS B4152 Fee Schedule
HCPCS B4152 is classified under Enteral and Parenteral Therapy, in the Enteral Formulas and Additives subgroup.
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit
| Key Fact | Detail |
|---|---|
| Service Type | Enteral and Parenteral Therapy Enteral Formulas and Additives |
| Complexity Level | Low |
| Medicaid Fee Schedule | $0.465 median of the 8 states in the free preview · View Medicaid rates for B4152 |
National average reimbursement for HCPCS B4152 by major payers:
$1.92
BCBS / Anthem
$0.52
UnitedHealthcare
$0.42
Aetna
$0.45
Cigna
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HCPCS B4152
5 of 25 sample ratesHigher to lower in this preview
Bradley Weisner
Urology Specialists Of The Carolinas, PLLC
$0.87Published rateDennis Crockett
Head And Neck Associates Of Orange County, Inc.
$0.63Published rateChristopher Raio
Mercy Medical Center
$0.62Published rateChristopher Raio
Mercy Medical Center
$0.15Published rateChristopher Raio
St Francis Hospital
$0.14Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS B4152 vs. Other Enteral Formulas and Additives Codes
The table lists codes related to B4152. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| B4150-HCPCS | Low | Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
| B4152-HCPCS | Low | Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
| B4153-HCPCS | Low | Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 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 B4152. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the B4152 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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