Prior Authorizations for Enteral Formula

June 4, 2013

When requesting Prior Authorizations (PAs) for enteral formula, please use modifier BO (orally administered nutrition, not by feeding tube) to the requested B codes to indicate if the member will be using this formula orally. To be reimbursed correctly, please remember to bill MaineCare using the exact code(s) with/without modifiers that appear on the PA approval letter. The BO modifier must be used for all orally administered enteral formula PAs requested on or after 06/01/2013.