Assistance Programs
ReimbursementMany state Medicaid programs and private payors will consider coverage of PediaSmart® for children when specific medical criteria is met. Nature's One® products have been assigned HCPCS codes by the Center for Medicare & Medicaid Services. Natures One® does not accept Medicare, Medicaid or private insurance directly. Instead, our products can be purchased through DME supply companies and pharmacies.
The HCPCS codes and NDC format codes are used for billing and reimbursement purposes. For coverage information, please direct questions to your state Medicaid office. Nature's One® has created a certificate of medical necessity for your convenience. This form includes nutritional information typically requested by private payers for review purposes. Please contact your insurance company directly as they may require additional information.
WIC EligibilityEach WIC State agency determines its own allowed formula list. This database is a national listing of eligible products. Contact your state WIC office to determine the availability of PediaSmart® in your area.
http://wicworks.nal.usda.gov/nal_web/wicworks/formulas/FormulaSearch.php.
Medical Hardship Discount ProgramFor patients who do not qualify for Medicare/Medicaid or private insurance coverage, Nature's One® offers a significant discount for children with serious medical conditions. The enrollment process requires doctor recommendation and application approval by Nature's One®.
Patients with medical conditions currently enrolled through this program include: Cancer, Celiac Disease, Cerebral Palsy, Eating Disorders, Cystic Fibrosis, Down Syndrome, Malabsorption Syndromes and Metabolic Disorders.
To enroll, go to Medical Hardship
| HCPCS & NDC Format Codes* | Nature's One® Products | Calories per Can |
|---|---|---|
| HCPCS: B4158 NDC: 16514-0229-00 |
Baby's Only Organic® Dairy Toddler Formula |
1680 Calories |
| HCPCS: B4158 NDC: 16514-2290-27 |
Baby's Only Organic® Dairy with DHA& ARA Toddler Formula |
1680 Calories |
| HCPCS: B4158 NDC: 16514-0229-03 |
Baby's Only Organic® Lactose Free Toddler Formula |
1680 Calories |
| HCPCS: B4159 NDC: 16514-0539-50 |
Baby's Only Organic® Soy Toddler Formula |
1680 Calories |
| HCPCS: B4160 NDC: 16514-0882-01 |
PediaSmart® Organic Dairy Nutritional Supplement (chocolate) |
1680 Calories |
| HCPCS: B4160 NDC: 16514-0881-01 |
PediaSmart® Organic Dairy Nutritional Supplement (vanilla) |
1680 Calories |
| HCPCS: B4160 NDC: 16514-0881-03 |
PediaSmart® Organic Soy Nutritional Supplement (vanilla) |
1680 Calories |
| HCPCS: B4103 NDC: NA |
PediaVance® Electrolyte Oral Maintenance Solution |
N/A |
*NDC Format Code Source: First Databank & Red Book
For questions regarding coverage, please contact your state Medicaid office or private insurance company. For Medicaid State by State Description and Plans, click on the following link: http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-State/By-State.html.










