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Your health insurance plan must cover the cost of a breast pump. It may be either a rental unit or a new one youll keep. Your plan may have guidelines on whether the covered pump is manual or electric, the length of the rental, and when youll receive it (before or after birth).
Medicare Coverage for Enteral Nutrition. Medicare covers enteral nutrition therapy and supplies at home for beneficiaries with permanent impairments. Feeding tubes, pumps and other supplies must be considered medically necessary and ordered by your doctor. You will pay 20 percent of the cost for these products.
Joint DME MAC Article Enteral nutrition is covered under the Prosthetic Device benefit (Social Security Act 1861(s)(8)). In order for a beneficiarys nutrition to be eligible for reimbursement the reasonable and necessary (RN) requirements set out in the National Coverage Determinations (NCD) Manual ( CMS Pub.
Medicare pays for no more than one months supply of enteral nutrients at any one time. If the claim involves a pump, it must be supported by sufficient medical documentation to establish that the pump is medically necessary, i.e., gravity feeding is not satisfactory due to aspiration, diarrhea, dumping syndrome.
Enteral feeding supply allowances (B4034, B4035, B4036, and B4148) include all supplies, other than the feeding tube and nutrients, required for the administration of enteral nutrients to the beneficiary for one day.

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Information describing the medical necessity for enteral nutrition must be available upon request. In order to satisfy the test of permanence, there must be documentation to reflect that in the treating practitioners judgement, the impairment will be of long and indefinite duration.

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