CommercialAdministrativeLow impact
08.00.18q, Nutritional Formulas, Enteral Nutrition, Medical Foods, Low-Protein Modified Food Products, and Donated Breast Milk
Independence Blue Cross·Gastroenterology, Pediatrics, Family Medicine +1 more·Medical Policy
Effective date
Oct 15, 2025
We identified it
Jun 19, 2026
Summary
This is a reissue of an existing policy covering nutritional formulas, enteral nutrition, medical foods, low-protein modified food products, and donated breast milk. The policy was reissued effective October 15, 2025, but no specific changes to coverage or billing requirements are detailed in this summary.
Action Required
By October 15, 2025: Billing team should review the full policy document at the provided URL to identify any changes to coverage criteria, prior authorization requirements, or billing procedures for nutritional formulas, enteral nutrition, medical foods, and donated breast milk. Update billing guidelines if changes are identified.