Arkansas Medicaid covers enteral and oral nutrition for children ages 5-21. Coverage includes up to 30 units or 3,000 calories per day and requires prior authorization to be renewed every 6 months. Acceptable diagnoses for coverage include conditions causing abnormal weight loss, feeding difficulties, and gastrointestinal issues. Prescriptions must be signed by a primary care physician and include the patient's daily caloric or product needs. Liquid thickeners for dysphagia are also covered up to 16 units per day. Finnegan Health provides free shipping of enteral supplies to patients.

1. www.FinneganHealth.com | 1-888-789-6600
Enteral and Oral Nutrition
Arkansas Medicaid Coverage Guidelines

2. Enteral and Oral Feeding Supplies are Covered
• Child must be 5-21 years old
• No dollar limit but maxed at 30 units/3,000 calories per day
• Quantity determined by Prescribed Caloric Need
• PA (Prior Authorization) is required for tube feeding every 6 months
• Medical Records are required yearly

3. What Diagnoses are Accepted by Medicaid?
For Enteral Feeding and Nutrition, Medicaid accepts ICD-10 DX of, or similar to:
R63.4 Abnormal weight loss
Z91.011 Allergy to milk products
R63.0 Anorexia
Z68.51 BMI pediatric, less than 5th percentile for age
Q67.0 Congenital facial asymmetry
F50.9 Eating disorder, unspecified
R62.51 Failure to thrive (child)

4. What Diagnoses are Accepted by Medicaid?
For Enteral Feeding and Nutrition, Medicaid accepts ICD-10 DX of, or similar to:
R63.3 Feeding difficulties
K21.0 Gastro-esophageal reflux disease with esophagitis
K21.9 Gastro-esophageal reflux disease without esophagitis
K92.2 Gastrointestinal hemorrhage, unspecified
Z93.1 Gastrostomy status
E44.0 Moderate protein-calorie malnutrition
R11.2 Nausea with vomiting, unspecified

5. What Diagnoses are Accepted by Medicaid?
For Enteral Feeding and Nutrition, Medicaid accepts ICD-10 DX of or similar to:
K91.2 Postsurgical malabsorption, not elsewhere classified
R63.6 Underweight
E46 Unspecified protein-calorie malnutrition
E63.9 Nutritional deficiency, unspecified
E41 Nutritional marasmus

6. What is Required on the Rx?
PCP MUST SIGN RX- surgeon or dietician is not acceptable
Rx must include:
Caloric Need Daily or Cans per Day- Max is 3,000 calories or 30 cans
Arkansas Medicaid will accept reasonable medical diagnoses
Secondary or Tertiary diagnoses may be required though not likely

7. A Note on Liquid and Food Thickeners
• Thickeners to treat Dysphagia, or Swallowing Difficulties
• Not subject to dollar limits but limited to 16 units per date of service
• Acceptable ICD-10 DXs: All forms of Dysphagia or Risk of Aspiration
• RX must include Frequency of taking Thickener & amount required per instance

8. Finnegan Health Ships to your Patient FREE
Enteral Feeding and Nutrition supplies-- picked up or shipped monthly
Shipping is 100% FREE to your patient but is NOT covered by Medicaid

11. www.FinneganHealth.com | 1-888-789-6600
Thank You.