Medicare Payment for PEN Supply Kits

Enteral care kits contain all the necessary supplies for the enteral patient using the syringe, gravity, or pump method of nutrient administration. Parenteral nutrition care kits and their components are considered all-inclusive items necessary to administer therapy during a monthly period.

The DMERC compares the enteral feeding care kits on the claim with the method of administration indicated on the CMN.
The allowance for the amount paid for a gravity-fed care kit is paid when a pump feeding kit is billed in the absence of documentation or unacceptable documentation for a pump.


Payment is denied for additional components included as part of the PEN supply kit.



Payment for Home Dialysis Supplies and Equipment



For dates of service prior to January 1, 2011, there are two methods of payment for home dialysis equipment and supplies: Method I and Method II. Under Method I, benefits are paid by a Medicare FI on the basis of a prospective payment, the composite rate. (See Chapters 8 and 12. for more information on establishing the composite rate). Under Method II, the DME MAC pays for supplies and services other than physician services. Physician services are paid at a monthly capitation rate by the local carrier. See Chapters 8 and 12 for more information on payment under Method II. For dates of service on and after January 1, 2011, please refer to Section 30.8.3 for information on the elimination of Method II home dialysis.