B4036 HCPCS code: Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape
B4036 is the HCPCS Level II code for enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape. In 2024 Medicare paid an average of $4.32 per service for B4036 across 1,020,267 services. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 1 per day on DME suppliers. Medicare volume fell 3% from 2022 to 2024 (1,056,769 to 1,020,267 services). In 2024, 931 suppliers billed Medicare for B4036 (purchases), serving 6,637 beneficiaries; California, Illinois, Texas accounted for 22% of services.
Code details
| Field | Value |
|---|---|
| Section | B codes — Enteral and parenteral therapy |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 39 — DMEPOS: parenteral and enteral nutrition |
| BETOS category | O1C — Enteral and parenteral nutrition |
| Added | 1986-01-01 |
| Last action effective | 2011-01-01 |
Who bills B4036 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 931 |
| Referring clinicians | 5,951 |
| Medicare beneficiaries | 6,637 |
| States with claims | 52 |
| Share of services in top 3 states (California, Illinois, Texas) | 22% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 950 | 6,850 |
| 2023 | 953 | 6,730 |
| 2024 | 931 | 6,637 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for B4036, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 1,056,769 | 6,850 | $5.28 | $4.10 |
| 2023 | 1,001,950 | 6,730 | $5.68 | $4.38 |
| 2024 | 1,020,267 | 6,637 | $5.60 | $4.32 |
States with the most B4036 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 88,424 | $3.91 |
| Illinois | 69,171 | $4.16 |
| Texas | 66,176 | $4.20 |
| Wisconsin | 58,262 | $4.34 |
| New York | 55,113 | $4.17 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 1 | Code Descriptor / CPT Instruction |
Medicare policy articles for this code
- A54563: Surgical Dressings - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
- A58833: Enteral Nutrition - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
Covered diagnoses (21 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| E08.69 | Diabetes mellitus due to underlying condition with other specified complication | 1 |
| E09.69 | Drug or chemical induced diabetes mellitus with other specified complication | 1 |
| E10.69 | Type 1 diabetes mellitus with other specified complication | 1 |
| E11.69 | Type 2 diabetes mellitus with other specified complication | 1 |
| E13.69 | Other specified diabetes mellitus with other specified complication | 1 |
| E84.19 | Cystic fibrosis with other intestinal manifestations | 1 |
| E84.8 | Cystic fibrosis with other manifestations | 1 |
| E84.9 | Cystic fibrosis, unspecified | 1 |
| K50.018 | Crohn's disease of small intestine with other complication | 1 |
| K50.118 | Crohn's disease of large intestine with other complication | 1 |
Showing 10 of 21. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for B4036
- 1986-01-01: B4036 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code B4036?
B4036 is the HCPCS Level II code for enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape. Short descriptor: "Enteral feed sup kit grav by".
How much does Medicare pay for B4036?
In 2024, the average Medicare payment was $4.32 per service (average allowed $5.60).
Does Medicare cover B4036?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for B4036?
Medicare policy articles that cite B4036 list 21 covered ICD-10-CM diagnosis codes across 2 articles. The most cited include E08.69 (Diabetes mellitus due to underlying condition with other specified complication), E09.69 (Drug or chemical induced diabetes mellitus with other specified complication), E10.69 (Type 1 diabetes mellitus with other specified complication). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of B4036 can be billed per day?
1 on DME suppliers (NCCI medically unlikely edits).
Related B40 codes
- B4034 — Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape
- B4035 — Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape
- B4081 — Nasogastric tubing with stylet
- B4082 — Nasogastric tubing without stylet
- B4083 — Stomach tube - levine type
- B4087 — Gastrostomy/jejunostomy tube, standard, any material, any type, each
- B4088 — Gastrostomy/jejunostomy tube, low-profile, any material, any type, each
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Next steps
- Run a reimbursement report for a device billed under B4036
- Watch B4036 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for B4036
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.