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Response to Comments: Enteral Nutrition DL38955
A58835
Noridian Healthcare Solutions, LLC (J19)
Effective: July 22, 2021
Updated: December 31, 2025
Policy Summary
The policy states that enteral nutrition therapy is covered for Medicare beneficiaries when there is full or partial non-function of structures that normally permit food to reach the small bowel, or when a disease impairs digestion or absorption necessitating enteral nutrition. Coverage determinations are based on the best available published clinical evidence (peer-reviewed research, systematic reviews, meta-analyses, consensus statements, and guidelines) in accordance with CMS Program Integrity Manual Chapter 13; public comments were solicited and reviewed during the comment period.
Coverage Criteria Preview
Key requirements from the full policy
"Enteral nutrition therapy is covered for Medicare beneficiaries who require enteral nutrition due to full or partial non-function of the anatomical structures that normally permit food to reach the..."
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