B4220 HCPCS code: Parenteral nutrition supply kit; premix, per day
B4220 is the HCPCS Level II code for parenteral nutrition supply kit; premix, per day. In 2024 Medicare paid an average of $8.87 per service for B4220 across 655,461 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 2% from 2022 to 2024 (669,164 to 655,461 services). In 2024, 477 suppliers billed Medicare for B4220 (purchases), serving 5,353 beneficiaries; California, New York, Pennsylvania accounted for 25% 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 | 1984-01-01 |
| Last action effective | 2002-01-01 |
Who bills B4220 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 477 |
| Referring clinicians | 5,511 |
| Medicare beneficiaries | 5,353 |
| States with claims | 54 |
| Share of services in top 3 states (California, New York, Pennsylvania) | 25% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 527 | 5,433 |
| 2023 | 483 | 5,430 |
| 2024 | 477 | 5,353 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for B4220, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 669,164 | 5,433 | $10.16 | $8.02 |
| 2023 | 666,061 | 5,430 | $11.02 | $8.63 |
| 2024 | 655,461 | 5,353 | $11.33 | $8.87 |
States with the most B4220 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 87,132 | $8.87 |
| New York | 40,838 | $8.88 |
| Pennsylvania | 37,867 | $8.88 |
| Florida | 35,416 | $8.88 |
| Texas | 32,455 | $8.87 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 1 | Code Descriptor / CPT Instruction |
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 B4220
- 1984-01-01: B4220 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 B4220?
B4220 is the HCPCS Level II code for parenteral nutrition supply kit; premix, per day. Short descriptor: "Parenteral supply kit premix".
How much does Medicare pay for B4220?
In 2024, the average Medicare payment was $8.87 per service (average allowed $11.33).
Does Medicare cover B4220?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of B4220 can be billed per day?
1 on DME suppliers (NCCI medically unlikely edits).
Related B42 codes
- B4216 — Parenteral nutrition; additives (vitamins, trace elements, heparin, electrolytes), home mix, per day
- B4222 — Parenteral nutrition supply kit; home mix, per day
- B4224 — Parenteral nutrition administration kit, per day
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under B4220
- Watch B4220 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for B4220
Sources: CMS HCPCS Level II release October 2026; 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.