Parenteral and Enteral Therapy

 
Insurance Information for Parenteral
and Enteral Therapy
 
Medicare covers enteral nutrients, supplies and equipment if the patient is unable
to digest or carry food to the small bowel to maintain weight and strength. This must
be a condition that is determined by the treating doctor to be permanent. Enteral
therapy is covered for patients who cannot swallow or take food orally. Nutrition must
be delivered through a tube directly into the gastrointestinal tract and may be given
by a syringe, gravity, or a pump.
 
Medicare covers parenteral nutrition only when the patient is unsuccessful using enteral
nutrition. Parenteral nutrition, administered through an intravenous line into the
bloodstream, is given to an individual whose gastrointestinal tract is unable to process
food normally, a result of either the patient's gastrointestinal tract is missing or not
functioning. This must be a condition that is determined by the treating doctor to be
permanent.
 
Medicare will not pay for nutritional formulas that are taken orally.
 
An order (prescription) must be on file with the supplier. It must be signed and dated
by the treating doctor.
 
Also, a DIF form (Durable Medical Equipment Information Form), which is completed
by the supplier, must be on file.
 
Most insurors follow similar coverage guidelines as Medicare for enteral and parenteral
nutrition.
 
If you have specific insurance questions, click here to contact HomeMedi Service.