Every policy word on this page is CMS's own. Verzi adds pins, receipts, and links only.
Enteral Nutrition
LCD L38955 · CMS's HCPCS descriptor for B4035: Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape.
Not on CMS's Required Prior Authorization List for DMEPOS on 2026-10-13. source
LCD L38955 · 6 versions, 2021 to today · last changed 2024-01-01 (R5)
Version 22 of LCD L38955: in force by CMS's dates 2023-10-01 to 2023-12-31. The policy text on this page comes from this archived version.
JA · Noridian 16013
JB · CGS 17013
JC · CGS 18003
JD · Noridian 19003
source
CMS's Who are the MACs jurisdiction pages (DME facts as of 2025-09-30) name each contractor and its states; the MCD's Contractor Information table on every DME LCD prints the contract numbers. Both read 2026-10-09. Verzi adds the state lookup only.
Sections in this version: Coverage Indications, Limitations, and/or Medical Necessity · Coding Information · Associated Information · Sources of Information. Plus 4 sections marked N/A in this version.
Full verbatim text serves to customers · Customer? Log in
Version history, LCD L38955
CMS numbers each version. Each box shows the version's window by CMS's stated dates. Select a version to show it on this page. Version numbers CMS never published to its archive do not exist as documents.
Revision history, every version
CMS's own change log, quoted, 5 entries. It does not change with the version shown. A revision (R-number) is a change CMS logged. The version (vN) is the snapshot that carries it.
R5 · 2024-01-01 · v24
Revision Effective Date: 01/01/2024 COVERAGE INDICATIONS, LIMITATIONS, AND/OR MEDICAL NECESSITY: Added: “and document an affirmative response” to language that pertains to contact with the beneficiary or caregiver/designee for DMEPOS products supplied as refills Revised: “approaching exhaustion” to “expected to end” in regard to existing supplies Revised: “Contact with the beneficiary or designee regarding refills must take place no sooner than 14 calendar days prior to the delivery/shipping date.” to “Contact with the beneficiary or designee regarding refills must take place no sooner than 30 calendar days prior to the expected end of the current supply.” Revised: “For delivery of refills, the supplier must deliver the DMEPOS product no sooner than 10 calendar days prior to the end of usage for the current product.” to “For delivery of refills, the supplier must deliver the DMEPOS product no sooner than 10 calendar days prior to the expected end of the current supply.” 12/14/2023: Pursuant to the 21st Century Cures Act, these revisions do not require notice and comment because the revisions are non-discretionary updates to refill requirement information per CMS Final Rule CMS-1780-F.
R4 · 2023-10-01 · v22
Revision Effective Date: 10/01/2023 COVERAGE INDICATIONS, LIMITATIONS, AND/OR MEDICAL NECESSITY: Revised: Language pertinent to the feeding supply allowance corresponding to the method of administration, to add “B4148” and “elastomeric control fed” Revised: Language pertinent to supply allowances, to add “B4148” SUMMARY OF EVIDENCE: Removed: Summary of evidence information, due to not being applicable to the non-discretionary changes ANALYSIS OF EVIDENCE (RATIONALE FOR DETERMINATION): Removed: Analysis of evidence information, due to not being applicable to the non-discretionary changes HCPCS CODES: Added: HCPCS code B4148 11/09/2023: Pursuant to the 21st Century Cures Act, these revisions do not require notice and comment because the revisions are non-discretionary updates per CMS HCPCS coding determinations.
R3 · 2023-07-02 · v20
Revision Effective Date: 07/02/2023 SUMMARY OF EVIDENCE: Added: Information related to GA, GY, GZ, and KX modifier addition ANALYSIS OF EVIDENCE: Added: Information related to GA, GY, GZ, and KX modifier addition CODING INFORMATION: Added: GA, GY, GZ, and KX modifiers RELATED LOCAL COVERAGE DOCUMENTS: Added: Response to Comments (A59397)
R2 · 2023-01-01 · v16
Revision Effective Date: 01/01/2023 COVERAGE INDICATIONS, LIMITATIONS, AND/OR MEDICAL NECESSITY: Revised: Language pertinent to the feeding supply allowance corresponding to the method of administration Revised: Reference to DIF question 5, to clarify it is for dates of services prior to January 1, 2023 SUMMARY OF EVIDENCE: Removed: Summary of evidence information, due to not being applicable to the non-discretionary changes ANALYSIS OF EVIDENCE (RATIONALE FOR DETERMINATION): Removed: Analysis of evidence information, due to not being applicable to the non-discretionary changes BIBLIOGRAPHY: Removed: Bibliography information, due to not being applicable to the non-discretionary changes 11/17/2022: Pursuant to the 21st Century Cures Act, these revisions do not require notice and comment because the revisions are non-discretionary updates due to CMS Change Request (CR) 12734: Elimination of Certificates of Medical Necessity and DME Information Forms.
R1 · 2022-01-01 · v8
Revision Effective Date: 01/01/2022 CMS NATIONAL COVERAGE POLICY: Removed: Reference to Medicare National Coverage Determinations Manual (CMS Pub. 100-03), Chapter 1, Part 3, Section 180.2. NCD was retired for claims with dates of service on and after January 1, 2022 03/10/2022: Pursuant to the 21st Century Cures Act, these revisions do not require notice and comment because the revisions are non-discretionary updates per CMS’ retiring of the National Coverage Determination.
Receipts for auditors
Version 22 of LCD L38955, shown on this page: in force by CMS's dates 2023-10-01 to 2023-12-31. Archived 2026-09-26. CMS's copy · Our archived file. 8 of 8 sections are proven word-identical to the archived file.
Every archived version of LCD L38955 (6 versions, CMS's dates, window by the as-of rule). The Article rows are the Article versions in force on the start dates of these LCD versions.
| Document | Version | In force | Archived on | Verify |
|---|---|---|---|---|
| LCD L38955 | version 5 | 2021-09-05 to 2021-12-31 | 2026-09-26 | CMS's copy · Our archived file |
| LCD L38955 | version 8 | 2022-01-01 to 2022-12-31 | 2026-09-26 | CMS's copy · Our archived file |
| LCD L38955 | version 16 | 2023-01-01 to 2023-07-01 | 2026-09-26 | CMS's copy · Our archived file |
| LCD L38955 | version 20 | 2023-07-02 to 2023-09-30 | 2026-09-26 | CMS's copy · Our archived file |
| LCD L38955 | version 22 shown | 2023-10-01 to 2023-12-31 | 2026-09-26 | CMS's copy · Our archived file |
| LCD L38955 | version 24 | 2024-01-01 to today | 2026-09-26 | CMS's copy · Our archived file |
| Article A55426 | version 91 | 2020-04-06 to 2022-12-31 | 2026-09-26 | CMS's copy · Our archived file |
| Article A55426 | version 103 | 2023-01-01 to 2023-12-31 | 2026-09-26 | CMS's copy · Our archived file |
| Article A55426 | version 132 | 2024-01-01 to today | 2026-09-26 | CMS's copy · Our archived file |
| Article A58833 | version 7 | 2021-09-05 to 2022-12-31 | 2026-09-26 | CMS's copy · Our archived file |
| Article A58833 | version 11 | 2023-01-01 to 2023-07-01 | 2026-09-26 | CMS's copy · Our archived file |
| Article A58833 | version 15 | 2023-07-02 to 2023-09-30 | 2026-09-26 | CMS's copy · Our archived file |
| Article A58833 | version 17 | 2023-10-01 to today | 2026-09-26 | CMS's copy · Our archived file |
Each archived file's page gives its sha256 fingerprint. A copy of the file hashes to the same value, byte for byte.
CMS's live page shows only the current version. To check a passage by eye, open CMS's copy of the same version number. A version's window ends on the earlier of CMS's stated end date and the day before the next version starts.
Every policy word on this page is CMS's, from the archived version named beside it. Verzi adds labels, highlights, citations and links only. Verzi-written summary content on this page: none.
Governing policies, as CMS lists them:
- LCD L38955 · Enteral Nutrition
CMS lists B4035 in group 1 of version 24. CMS's description, quoted: “ENTERAL FEEDING SUPPLY KIT; PUMP FED, PER DAY, INCLUDES BUT NOT LIMITED TO FEEDING/FLUSHING SYRINGE, ADMINISTRATION SET TUBING, DRESSINGS, TAPE”.
Related Articles, as CMS lists them: Article A55426 · Article A58833 · Article A59397
From CMS's LCD code table. HCPCS Level II codes only.
source
CMS's LCD code table in the Medicare Coverage Database download, archived 2026-10-09: Our archived file.
Watch B4035
One email when any policy cited for B4035 changes or gains a future effective date. Nothing else, ever.