B4220 — Parenteral nutrition supply kit; premix, per day
B4220 is a HCPCS Level II code for parenteral nutrition supply kit; premix, per day. It belongs to the Enteral and Parenteral Therapy section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Special coverage instructions apply
There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Medically Unlikely Edits — units per day
The most units of B4220 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- outpatient
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- DME supplier
- 1 unit MAI 1 — Line Edit · Code Descriptor / CPT Instruction
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for B4220
- Long descriptor
- Parenteral nutrition supply kit; premix, per day
- Short descriptor
- Parenteral supply kit premix
- Added
- January 1, 1984
- BETOS
- O1C
- Pricing indicator
- 39 — DMEPOS
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Parenteral and enteral nutrition.
Codes adjacent to B4220
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If B4220 is not quite right, the correct code is very often within a few positions of it.
- B4180Parenteral nutrition solution; carbohydrates (dextrose), greater than 50% (500 ml = 1 unit) - home mix
- B4185Parenteral nutrition solution, not otherwise specified, 10 grams lipids
- B4187Omegaven, 10 grams lipids
- B4189Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 10 to 51 grams of protein - premix
- B4193Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 52 to 73 grams of protein - premix
- B4197Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, 74 to 100 grams of protein - premix
- B4199Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, over 100 grams of protein - premix
- B4216Parenteral nutrition; additives (vitamins, trace elements, heparin, electrolytes), home mix, per day
- B4222Parenteral nutrition supply kit; home mix, per day
- B4224Parenteral nutrition administration kit, per day
- B5000Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, renal-aminosyn-rf, nephramine, renamine-premix
- B5100Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, hepatic, hepatamine-premix
- B5200Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, stress-branch chain amino acids-freamine-hbc-premix
- B9000Enteral nutrition infusion pump - without alarmterminated
- B9002Enteral nutrition infusion pump, any type
- B9004Parenteral nutrition infusion pump, portable
Questions about B4220
What is HCPCS code B4220?
B4220 is a HCPCS Level II code for parenteral nutrition supply kit; premix, per day. It sits in the Enteral and Parenteral Therapy section.
Does Medicare cover B4220?
The CMS HCPCS file marks B4220 as "Special coverage instructions apply". There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.