Support Medically Appropriate Real Food Options in Tube Feeding
The Issue
Under the current Medicare Part B reimbursement model for enteral nutrition, Americans who eat via feeding tube lack coverage for enteral nutrition in line with the Dietary Guidelines.
Today, Medicare beneficiaries relying on enteral nutrition through Medicare Part B are denied access to real-food enteral nutrition products unless they prove failure to tolerate a standard enteral nutrition formula. These standard formulas, billed under HCPCS codes b4150 and b4152, contain added sugar with no meaningful amounts of fruits, vegetables, or whole grains.
This stands in direct contrast to federal nutrition guidance for Medicare's recipients.
The Dietary Guidelines for Americans emphasize minimizing added sugars and promoting dietary patterns rich in fruits, vegetables, legumes, and whole grains for lifelong health. CMS has also reinforced in guidance to hospitals that medical nutrition therapy interventions should align with the Dietary Guidelines whenever possible.
For the majority of enteral nutrition patients, this is possible in the form of blenderized enteral nutrition products (coded as b4149).
Blenderized enteral products provide nutritionally complete options made from food in line with the Dietary Guidelines, and free of added sugars. Yet under current reimbursement policy, patients must first experience intolerance or medical complications with a standard formula before coverage of a blenderized or real-food formula is considered.
No other medical population is required to prove they cannot tolerate processed foods with added sugars before being allowed access to whole-food nutrition.
We respectfully ask Congress to:
- Align Medicare enteral nutrition policy with the Dietary Guidelines for Americans. Allow Medicare Part B recipients of enteral nutrition access to b4149 Blenderized Food products.
- Reform reimbursement for blenderized tube feeding products to align with the cost of production, ensuring Durable Medical Equipment providers can sustainably provide these products to patients for whom they are prescribed.
We call on Congress to champion reform that protects the dignity, health, and right of Americans with feeding tubes to access food in line with the Dietary Guidelines.
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The Issue
Under the current Medicare Part B reimbursement model for enteral nutrition, Americans who eat via feeding tube lack coverage for enteral nutrition in line with the Dietary Guidelines.
Today, Medicare beneficiaries relying on enteral nutrition through Medicare Part B are denied access to real-food enteral nutrition products unless they prove failure to tolerate a standard enteral nutrition formula. These standard formulas, billed under HCPCS codes b4150 and b4152, contain added sugar with no meaningful amounts of fruits, vegetables, or whole grains.
This stands in direct contrast to federal nutrition guidance for Medicare's recipients.
The Dietary Guidelines for Americans emphasize minimizing added sugars and promoting dietary patterns rich in fruits, vegetables, legumes, and whole grains for lifelong health. CMS has also reinforced in guidance to hospitals that medical nutrition therapy interventions should align with the Dietary Guidelines whenever possible.
For the majority of enteral nutrition patients, this is possible in the form of blenderized enteral nutrition products (coded as b4149).
Blenderized enteral products provide nutritionally complete options made from food in line with the Dietary Guidelines, and free of added sugars. Yet under current reimbursement policy, patients must first experience intolerance or medical complications with a standard formula before coverage of a blenderized or real-food formula is considered.
No other medical population is required to prove they cannot tolerate processed foods with added sugars before being allowed access to whole-food nutrition.
We respectfully ask Congress to:
- Align Medicare enteral nutrition policy with the Dietary Guidelines for Americans. Allow Medicare Part B recipients of enteral nutrition access to b4149 Blenderized Food products.
- Reform reimbursement for blenderized tube feeding products to align with the cost of production, ensuring Durable Medical Equipment providers can sustainably provide these products to patients for whom they are prescribed.
We call on Congress to champion reform that protects the dignity, health, and right of Americans with feeding tubes to access food in line with the Dietary Guidelines.
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Petition created on May 13, 2026