Medicaid HCPCS Codes
HCPCS Level II Codes for Nature's One® ProductsNature’s One® is providing the following information to assist customers who qualify for Medicare & Medicaid Services (CMS) in obtaining coverage for the products listed below. The HCPCS Level II codes are available for use by all payers and are maintained by the CMS.
According to CMS, “The Level II HCPCS is a standardized coding system that is used primarily to identify products, supplies, and services not included in the CPT-4 codes. HCPCS is not a methodology or system for making coverage or payment determinations, and the existence of a code does not, of itself, determine coverage or non-coverage for an item or service. The Level II HCPCS is maintained and distributed by CMS, in conjunction with private payer organizations.”1
| HCPCS Codes | NDC Format # | Nature's One® Products | Protein Type & Flavor |
|---|---|---|---|
| B4158 | 16514-2290-03 | Baby's Only Organic® Dairy Toddler Formula |
Dairy-based |
| B4158 | 16514-2290-34 | Baby's Only Organic® Lactose Free Toddler Formula |
Lactose Free, Milk-based |
| B4159 | 16514-5395-08 | Baby's Only Organic® Soy Toddler Formula |
Soy-based |
| B4160 | 16514-8820-17 | PediaSmart® Organic Nutritional Beverage |
Dairy-based, Lactose Free Chocolate Flavor |
| B4160 | 16514-8810-10 | PediaSmart® Organic Nutritional Beverage |
Dairy-based, Lactose Free Vanilla Flavor |
| B4103 | 16514-9246-32 | PediaVance® Electrolyte Oral Maintenance Solution |
Apple Flavor | B4103 | 16514-9146-33 | PediaVance® Electrolyte Oral Maintenance Solution |
Grape Flavor |
For questions regarding coverage, please contact your state Medicaid office or private insurance company. Below are websites for The Centers for Medicare & Medicaid Services.
- For General Medicaid Information: http://www.cms.hhs.gov/home/medicaid.asp
- Medicaid State by State Description and Plans: http://64.82.65.67/medicaid/states.html
