Enterade® may be eligible for reimbursement from most private health insurance plans when prescribed for a covered medical need.  Coverage depends on the insurance provider and plan.

As the manufacturer, Enterade cannot bill insurance directly.

Check with your health insurance provider to find out if your policy provides coverage, call the member services phone number listed on the back of your insurance card.  When you call, tell the representative the provided HCPCS and/or NDC Code Listed below.


Enterade® AO Vanilla
  • HCPCS Code Use B4102 (Adults) , B4103 (Pediatrics) and NDC Code 28028-0353-89
Enterade® AO Orange
  • HCPCS Code Use B4102 (Adults) , B4103 (Pediatrics) and NDC Code 99422-0992-48

To submit for reimbursement, follow the steps below:

You must have a prescription from a physician
1. Should read- enterade 2x/day x 30 days plus 2 refills (allows for usage throughout Tx)
2. Needs to include diagnosis/reimbursement codes (ICD 10)- example of some codes:

a. Leaky gut syndrome: K59.9
b. Diarrhea: R19.7
c. Electrolyte imbalance: E87.8
d. Colostomy status: Z93.3
e. Dehydration: E86.0
f. Short gut syndrome: K91.2
g. Ileostomy status: Z93.2
h. Irritable bowel syndrome: K58.9


If required have your doctor complete the medical necessity form. You can print out sample copy <here>


For Flexible Spending / Health Spending Accounts (FSA/HSA)

1.) Obtain a prescription as outlined above
2.) Purchase the product
3.) Submit to your FDA carrier for reimbursement- prescription and copy of your receipt.

 

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