B4187 HCPCS code: Omegaven, 10 grams lipids
B4187 is the HCPCS Level II code for omegaven, 10 grams lipids. In 2024 Medicare paid an average of $12.40 per service for B4187 across 8,565 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 15 per day on DME suppliers. Medicare volume rose 5% from 2022 to 2024 (8,128 to 8,565 services). In 2024, 16 suppliers billed Medicare for B4187 (purchases), serving 13 beneficiaries; Massachusetts, Alabama, Georgia accounted for 72% 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 | 2020-01-01 |
| Last action effective | 2020-01-01 |
Who bills B4187 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 16 |
| Referring clinicians | 21 |
| Medicare beneficiaries | 13 |
| States with claims | 7 |
| Share of services in top 3 states (Massachusetts, Alabama, Georgia) | 72% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 22 | 21 |
| 2023 | 14 | 12 |
| 2024 | 16 | 13 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for B4187, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 8,128 | 21 | $13.77 | $10.88 |
| 2023 | 6,145 | 12 | $15.49 | $12.09 |
| 2024 | 8,565 | 13 | $15.91 | $12.40 |
States with the most B4187 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Massachusetts | 2,430 | $12.39 |
| Alabama | 1,940 | $12.47 |
| Georgia | 1,765 | $12.36 |
| California | 824 | $12.40 |
| New York | 811 | $12.47 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 15 | Prescribing Information |
Medicare policy articles for this code
- A58836: Parenteral Nutrition (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
What changed for B4187
- 2020-01-01: B4187 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 B4187?
B4187 is the HCPCS Level II code for omegaven, 10 grams lipids. Short descriptor: "Omegaven, 10 grams lipids".
How much does Medicare pay for B4187?
In 2024, the average Medicare payment was $12.40 per service (average allowed $15.91).
Does Medicare cover B4187?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of B4187 can be billed per day?
15 on DME suppliers (NCCI medically unlikely edits).
Related B41 codes
- B4100 — Food thickener, administered orally, per ounce
- B4102 — Enteral formula, for adults, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit
- B4103 — Enteral formula, for pediatrics, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit
- B4104 — Additive for enteral formula (e.g., fiber)
- B4105 — In-line cartridge containing digestive enzyme(s) for enteral feeding, each
- B4148 — Enteral feeding supply kit; elastomeric control fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape
- B4149 — Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit
- B4150 — Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit
- B4152 — Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit
- B4153 — Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit
- B4154 — Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit
- B4155 — Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 unit
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Next steps
- Run a reimbursement report for a device billed under B4187
- Watch B4187 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for B4187
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.