MEDICAID HCPCS CODES

Medicaid HCPCS Codes

HCPCS Level II Codes for Nature's One® Products

Nature’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. Natures One® does not accept Medicaid or Medicare directly. Instead, our products can be purchased through medical supply companies and pharmacies. The HCPCS codes below are used by medical suppliers and pharmacies for billing purposes. For coverage information, please direct questions to your state Medicaid office or private insurance company.

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 Nature's One® Products Protein Type & Flavor
B4158 Baby's Only Organic®
Dairy Toddler Formula
Dairy-based
B4158 Baby's Only Organic®
Lactose Free Toddler Formula
Lactose Free, Milk-based
B4159 Baby's Only Organic®
Soy Toddler Formula
Soy-based
B4160 PediaSmart®
Organic Nutritional Beverage
Dairy-based, Lactose Free
Chocolate Flavor
B4160 PediaSmart®
Organic Nutritional Beverage
Dairy-based, Lactose Free
Vanilla Flavor
B4103 PediaVance® Electrolyte
Oral Maintenance Solution
Apple Flavor
B4103 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.