If a thickener is medically necessary, it may be covered by insurance. Coverage depends on your specific insurance plan and, for Medicaid, your state’s program.
If you have private or employer-sponsored insurance, coverage for thickeners varies by plan. Many plans consider oral food thickeners under the Durable Medical Equipment (DME) benefit when medically necessary.
Call the member services number on the back of your insurance card and ask:
-Are oral food thickeners covered under HCPCS Code B4100 (food thickener, administered orally, per ounce)?
-Is this covered under my Durable Medical Equipment (DME) benefit?
-Is prior authorization required?
-Do I need a prescription or Letter of Medical Necessity?
-Am I required to use an in-network DME supplier?
If coverage is available, your healthcare provider will typically provide a prescription and/or Letter of Medical Necessity. The DME supplier will submit the claim to your insurance on your behalf. If your plan does not cover thickeners, you may ask about submitting a member reimbursement claim or filing an appeal with supporting documentation from your provider.
Medicaid coverage for thickeners is determined by each individual state. In many states, thickeners are billed under HCPCS Code B4100 and may be covered through the Durable Medical Equipment (DME) benefit. In some states, coverage may instead fall under the pharmacy (OTC) benefit.
Coverage levels and reimbursement rates vary by state, which can affect product availability through DME suppliers. Check your state below to see:
-Whether coverage is considered favorable
-How thickeners are typically billed (DME or pharmacy benefit)
-Any important state-specific notes
If coverage is available in your state, your healthcare provider will need to submit a prescription and/or Letter of Medical Necessity to a Medicaid-enrolled supplier.
This information is gathered from publicly available sources and is subject to change. We strive to provide accurate and up-to-date information but cannot guarantee coverage. For the most current details, please contact your state Medicaid office or managed care plan directly. If you notice inaccurate information, please email contact@healthierthickening.com.
Favorable for Coverage: Pharmacy Benefit (OTC)
Gelmix and Purathick are favorable for coverage as over-the-counter (OTC) products with a prescription under the pharmacy benefit.
Requirements
-Prescription required
-Prior Authorization required (must include quantity, day supply, diagnosis, and applicable ICD-10 codes; refer to the resources below for full PA requirements)
Product NDC Codes in AL
-Gelmix Infant Thickener (Sticks): 55764-0007-11
-Purathick Natural Thickener (Sticks): 55764-0007-14
Resources / Links
Miscellaneous Prior Authorization Form
NDC Lookup Tool
Medicaid Coverage Needs Improvement. This state currently provides coverage for thickeners through DME reimbursement code B4100 (or B4100-U1). However, the reimbursement rate may be too low or is currently unclear, which can make it challenging for suppliers to offer low-weight, gum-based thickeners like Gelmix and Purathick. Advocating for updates to the Medicaid reimbursement schedule to a cost-plus model could ensure better access to these essential products. Medicaid recipients qualify for our WeCare patient assistance program to purchase Gelmix and Purathick at a discounted rate to ensure greater accessibility. Click here to learn more.
Edgepark is a division of Cardinal Health with direct shipment to your home. Pricing is determined once insurance and patient information has been entered during checkout.
Physician’s Written Order Form
my.edgepark.com
1-888-394-5375
Gelmix Jar: PPTGELWHO004
Purathick Jar: PPTPURWHO001N
Favorable for Coverage by Medicaid. This state provides favorable Medicaid coverage for thickeners through DME reimbursement code B4100, utilizing cost-plus reimbursement rates. Gelmix and Purathick are typically covered.
Submit Referral and Request Services
866-883-1188
Edgepark is a division of Cardinal Health with direct shipment to your home. Pricing is determined once insurance and patient information has been entered during checkout.
Physician’s Written Order Form
my.edgepark.com
1-888-394-5375
Gelmix Jar: PPTGELWHO004
Purathick Jar: PPTPURWHO001N
Medicaid Coverage Needs Improvement. This state currently provides coverage for thickeners through DME reimbursement code B4100 (or B4100-U1). However, the reimbursement rate may be too low or is currently unclear, which can make it challenging for suppliers to offer low-weight, gum-based thickeners like Gelmix and Purathick. Advocating for updates to the Medicaid reimbursement schedule to a cost-plus model could ensure better access to these essential products. Medicaid recipients qualify for our WeCare patient assistance program to purchase Gelmix and Purathick at a discounted rate to ensure greater accessibility. Click here to learn more.
Not Covered by Medicaid. Currently, this state does not provide Medicaid coverage for thickeners, as they are not typically classified as a medical necessity. While no thickeners are covered at this time, advocacy efforts can help bring attention to the importance of these products for individuals with specific dietary needs. Medicaid recipients qualify for our WeCare patient assistance program to purchase Gelmix and Purathick at a discounted rate to ensure greater accessibility, Click here to learn more.
Favorable for Coverage by Medicaid. This state provides favorable Medicaid coverage for thickeners through DME reimbursement code B4100, utilizing cost-plus reimbursement rates. Gelmix and Purathick are typically covered.
Submit Referral and Request Services
866-883-1188
Edgepark is a division of Cardinal Health with direct shipment to your home. Pricing is determined once insurance and patient information has been entered during checkout.
Physician’s Written Order Form
my.edgepark.com
1-888-394-5375
Gelmix Jar: PPTGELWHO004
Purathick Jar: PPTPURWHO001N
Medicaid Coverage Unknown. Check back for updates.
Edgepark is a division of Cardinal Health with direct shipment to your home. Pricing is determined once insurance and patient information has been entered during checkout.
Physician’s Written Order Form
my.edgepark.com
1-888-394-5375
Gelmix Jar: PPTGELWHO004
Purathick Jar: PPTPURWHO001N
Medicaid Coverage Unknown. Check back for updates.
Not Covered by Medicaid. Currently, this state does not provide Medicaid coverage for thickeners, as they are not typically classified as a medical necessity. While no thickeners are covered at this time, advocacy efforts can help bring attention to the importance of these products for individuals with specific dietary needs. Medicaid recipients qualify for our WeCare patient assistance program to purchase Gelmix and Purathick at a discounted rate to ensure greater accessibility, Click here to learn more.
4529 N. Pine Island Rd.
Sunrise, FL 33351
ph: 888-389-2014
fx: 888-200-3285
Not Covered by Medicaid. Currently, this state does not provide Medicaid coverage for thickeners, as they are not typically classified as a medical necessity. While no thickeners are covered at this time, advocacy efforts can help bring attention to the importance of these products for individuals with specific dietary needs. Medicaid recipients qualify for our WeCare patient assistance program to purchase Gelmix and Purathick at a discounted rate to ensure greater accessibility, Click here to learn more.
Medicaid Coverage Needs Improvement. This state currently provides coverage for thickeners through DME reimbursement code B4100 (or B4100-U1). However, the reimbursement rate may be too low or is currently unclear, which can make it challenging for suppliers to offer low-weight, gum-based thickeners like Gelmix and Purathick. Advocating for updates to the Medicaid reimbursement schedule to a cost-plus model could ensure better access to these essential products. Medicaid recipients qualify for our WeCare patient assistance program to purchase Gelmix and Purathick at a discounted rate to ensure greater accessibility. Click here to learn more.
Medicaid Coverage Unknown. Check back for updates.
Edgepark is a division of Cardinal Health with direct shipment to your home. Pricing is determined once insurance and patient information has been entered during checkout.
Physician’s Written Order Form
my.edgepark.com
1-888-394-5375
Gelmix Jar: PPTGELWHO004
Purathick Jar: PPTPURWHO001N
Medicaid Coverage Needs Improvement. This state currently provides coverage for thickeners through DME reimbursement code B4100 (or B4100-U1). However, the reimbursement rate may be too low or is currently unclear, which can make it challenging for suppliers to offer low-weight, gum-based thickeners like Gelmix and Purathick. Advocating for updates to the Medicaid reimbursement schedule to a cost-plus model could ensure better access to these essential products. Medicaid recipients qualify for our WeCare patient assistance program to purchase Gelmix and Purathick at a discounted rate to ensure greater accessibility. Click here to learn more.
Edgepark is a division of Cardinal Health with direct shipment to your home. Pricing is determined once insurance and patient information has been entered during checkout.
Physician’s Written Order Form
my.edgepark.com
1-888-394-5375
Gelmix Jar: PPTGELWHO004
Purathick Jar: PPTPURWHO001N
Favorable for Coverage by Medicaid. This state provides favorable Medicaid coverage for thickeners through DME reimbursement code B4100, utilizing cost-plus reimbursement rates. Gelmix and Purathick are typically covered.
Submit Referral and Request Services
866-883-1188
Edgepark is a division of Cardinal Health with direct shipment to your home. Pricing is determined once insurance and patient information has been entered during checkout.
Physician’s Written Order Form
my.edgepark.com
1-888-394-5375
Gelmix Jar: PPTGELWHO004
Purathick Jar: PPTPURWHO001N
Medicaid Coverage Unknown. Check back for updates.
Edgepark is a division of Cardinal Health with direct shipment to your home. Pricing is determined once insurance and patient information has been entered during checkout.
Physician’s Written Order Form
my.edgepark.com
1-888-394-5375
Gelmix Jar: PPTGELWHO004
Purathick Jar: PPTPURWHO001N
Favorable for Coverage by Medicaid. This state provides favorable Medicaid coverage for thickeners through DME reimbursement code B4100, utilizing cost-plus reimbursement rates. Gelmix and Purathick are typically covered.
Edgepark is a division of Cardinal Health with direct shipment to your home. Pricing is determined once insurance and patient information has been entered during checkout.
Physician’s Written Order Form
my.edgepark.com
1-888-394-5375
Gelmix Jar: PPTGELWHO004
Purathick Jar: PPTPURWHO001N
Medicaid Coverage Needs Improvement. This state currently provides coverage for thickeners through DME reimbursement code B4100 (or B4100-U1). However, the reimbursement rate may be too low or is currently unclear, which can make it challenging for suppliers to offer low-weight, gum-based thickeners like Gelmix and Purathick. Advocating for updates to the Medicaid reimbursement schedule to a cost-plus model could ensure better access to these essential products. Medicaid recipients qualify for our WeCare patient assistance program to purchase Gelmix and Purathick at a discounted rate to ensure greater accessibility. Click here to learn more.
Medicaid Coverage Unknown. Check back for updates.
Medicaid Coverage Needs Improvement. This state currently provides coverage for thickeners through DME reimbursement code B4100 (or B4100-U1). However, the reimbursement rate may be too low or is currently unclear, which can make it challenging for suppliers to offer low-weight, gum-based thickeners like Gelmix and Purathick. Advocating for updates to the Medicaid reimbursement schedule to a cost-plus model could ensure better access to these essential products. Medicaid recipients qualify for our WeCare patient assistance program to purchase Gelmix and Purathick at a discounted rate to ensure greater accessibility. Click here to learn more.
Favorable for Coverage by Medicaid. This state provides favorable Medicaid coverage for thickeners through DME reimbursement code B4100, utilizing cost-plus reimbursement rates. Gelmix and Purathick are typically covered.
Submit Referral and Request Services
866-883-1188
Edgepark is a division of Cardinal Health with direct shipment to your home. Pricing is determined once insurance and patient information has been entered during checkout.
Physician’s Written Order Form
my.edgepark.com
1-888-394-5375
Gelmix Jar: PPTGELWHO004
Purathick Jar: PPTPURWHO001N
Favorable for Coverage by Medicaid. This state provides favorable Medicaid coverage for thickeners through DME reimbursement code B4100, utilizing cost-plus reimbursement rates. Gelmix and Purathick are typically covered.
Edgepark is a division of Cardinal Health with direct shipment to your home. Pricing is determined once insurance and patient information has been entered during checkout.
Physician’s Written Order Form
my.edgepark.com
1-888-394-5375
Gelmix Jar: PPTGELWHO004
Purathick Jar: PPTPURWHO001N
Medicaid Coverage Needs Improvement. This state currently provides coverage for thickeners through DME reimbursement code B4100 (or B4100-U1). However, the reimbursement rate may be too low or is currently unclear, which can make it challenging for suppliers to offer low-weight, gum-based thickeners like Gelmix and Purathick. Advocating for updates to the Medicaid reimbursement schedule to a cost-plus model could ensure better access to these essential products. Medicaid recipients qualify for our WeCare patient assistance program to purchase Gelmix and Purathick at a discounted rate to ensure greater accessibility. Click here to learn more.
Medicaid Coverage Needs Improvement. This state currently provides coverage for thickeners through DME reimbursement code B4100 (or B4100-U1). However, the reimbursement rate may be too low or is currently unclear, which can make it challenging for suppliers to offer low-weight, gum-based thickeners like Gelmix and Purathick. Advocating for updates to the Medicaid reimbursement schedule to a cost-plus model could ensure better access to these essential products. Medicaid recipients qualify for our WeCare patient assistance program to purchase Gelmix and Purathick at a discounted rate to ensure greater accessibility. Click here to learn more.
Favorable for Coverage by Medicaid. This state provides favorable Medicaid coverage for thickeners through DME reimbursement code B4100, utilizing cost-plus reimbursement rates. Gelmix and Purathick are typically covered.
Submit Referral and Request Services
866-883-1188
Edgepark is a division of Cardinal Health with direct shipment to your home. Pricing is determined once insurance and patient information has been entered during checkout.
Physician’s Written Order Form
my.edgepark.com
1-888-394-5375
Gelmix Jar: PPTGELWHO004
Purathick Jar: PPTPURWHO001N
Medicaid Coverage Unknown. Check back for updates.
Edgepark is a division of Cardinal Health with direct shipment to your home. Pricing is determined once insurance and patient information has been entered during checkout.
Physician’s Written Order Form
my.edgepark.com
1-888-394-5375
Gelmix Jar: PPTGELWHO004
Purathick Jar: PPTPURWHO001N
Medicaid Coverage Needs Improvement. This state currently provides coverage for thickeners through DME reimbursement code B4100 (or B4100-U1). However, the reimbursement rate may be too low or is currently unclear, which can make it challenging for suppliers to offer low-weight, gum-based thickeners like Gelmix and Purathick. Advocating for updates to the Medicaid reimbursement schedule to a cost-plus model could ensure better access to these essential products. Medicaid recipients qualify for our WeCare patient assistance program to purchase Gelmix and Purathick at a discounted rate to ensure greater accessibility. Click here to learn more.
Edgepark is a division of Cardinal Health with direct shipment to your home. Pricing is determined once insurance and patient information has been entered during checkout.
Physician’s Written Order Form
my.edgepark.com
1-888-394-5375
Gelmix Jar: PPTGELWHO004
Purathick Jar: PPTPURWHO001N
Medicaid Coverage Unknown. Check back for updates.
Edgepark is a division of Cardinal Health with direct shipment to your home. Pricing is determined once insurance and patient information has been entered during checkout.
Physician’s Written Order Form
my.edgepark.com
1-888-394-5375
Gelmix Jar: PPTGELWHO004
Purathick Jar: PPTPURWHO001N
Medicaid Coverage Needs Improvement. This state currently provides coverage for thickeners through DME reimbursement code B4100 (or B4100-U1). However, the reimbursement rate may be too low or is currently unclear, which can make it challenging for suppliers to offer low-weight, gum-based thickeners like Gelmix and Purathick. Advocating for updates to the Medicaid reimbursement schedule to a cost-plus model could ensure better access to these essential products. Medicaid recipients qualify for our WeCare patient assistance program to purchase Gelmix and Purathick at a discounted rate to ensure greater accessibility. Click here to learn more.
Medicaid Coverage Needs Improvement. This state currently provides coverage for thickeners through DME reimbursement code B4100 (or B4100-U1). However, the reimbursement rate may be too low or is currently unclear, which can make it challenging for suppliers to offer low-weight, gum-based thickeners like Gelmix and Purathick. Advocating for updates to the Medicaid reimbursement schedule to a cost-plus model could ensure better access to these essential products. Medicaid recipients qualify for our WeCare patient assistance program to purchase Gelmix and Purathick at a discounted rate to ensure greater accessibility. Click here to learn more.
Medicaid Coverage Needs Improvement. This state currently provides coverage for thickeners through DME reimbursement code B4100 (or B4100-U1). However, the reimbursement rate may be too low or is currently unclear, which can make it challenging for suppliers to offer low-weight, gum-based thickeners like Gelmix and Purathick. Advocating for updates to the Medicaid reimbursement schedule to a cost-plus model could ensure better access to these essential products. Medicaid recipients qualify for our WeCare patient assistance program to purchase Gelmix and Purathick at a discounted rate to ensure greater accessibility. Click here to learn more.
Edgepark is a division of Cardinal Health with direct shipment to your home. Pricing is determined once insurance and patient information has been entered during checkout.
Physician’s Written Order Form
my.edgepark.com
1-888-394-5375
Gelmix Jar: PPTGELWHO004
Purathick Jar: PPTPURWHO001N
Not Covered by Medicaid. Currently, this state does not provide Medicaid coverage for thickeners, as they are not typically classified as a medical necessity. While no thickeners are covered at this time, advocacy efforts can help bring attention to the importance of these products for individuals with specific dietary needs. Medicaid recipients qualify for our WeCare patient assistance program to purchase Gelmix and Purathick at a discounted rate to ensure greater accessibility, Click here to learn more.
Medicaid Coverage Needs Improvement. This state currently provides coverage for thickeners through DME reimbursement code B4100 (or B4100-U1). However, the reimbursement rate may be too low or is currently unclear, which can make it challenging for suppliers to offer low-weight, gum-based thickeners like Gelmix and Purathick. Advocating for updates to the Medicaid reimbursement schedule to a cost-plus model could ensure better access to these essential products. Medicaid recipients qualify for our WeCare patient assistance program to purchase Gelmix and Purathick at a discounted rate to ensure greater accessibility. Click here to learn more.
Medicaid Coverage Needs Improvement. This state currently provides coverage for thickeners through DME reimbursement code B4100 (or B4100-U1). However, the reimbursement rate may be too low or is currently unclear, which can make it challenging for suppliers to offer low-weight, gum-based thickeners like Gelmix and Purathick. Advocating for updates to the Medicaid reimbursement schedule to a cost-plus model could ensure better access to these essential products. Medicaid recipients qualify for our WeCare patient assistance program to purchase Gelmix and Purathick at a discounted rate to ensure greater accessibility. Click here to learn more.
Edgepark is a division of Cardinal Health with direct shipment to your home. Pricing is determined once insurance and patient information has been entered during checkout.
Physician’s Written Order Form
my.edgepark.com
1-888-394-5375
Gelmix Jar: PPTGELWHO004
Purathick Jar: PPTPURWHO001N
Medicaid Coverage Needs Improvement. This state currently provides coverage for thickeners through DME reimbursement code B4100 (or B4100-U1). However, the reimbursement rate may be too low or is currently unclear, which can make it challenging for suppliers to offer low-weight, gum-based thickeners like Gelmix and Purathick. Advocating for updates to the Medicaid reimbursement schedule to a cost-plus model could ensure better access to these essential products. Medicaid recipients qualify for our WeCare patient assistance program to purchase Gelmix and Purathick at a discounted rate to ensure greater accessibility. Click here to learn more.
1101 W. Vickery Blvd.
Fort Worth, TX 76104
ph: 800-747-8242
fx: 682-885-8409
Medicaid Coverage Needs Improvement. This state currently provides coverage for thickeners through DME reimbursement code B4100 (or B4100-U1). However, the reimbursement rate may be too low or is currently unclear, which can make it challenging for suppliers to offer low-weight, gum-based thickeners like Gelmix and Purathick. Advocating for updates to the Medicaid reimbursement schedule to a cost-plus model could ensure better access to these essential products. Medicaid recipients qualify for our WeCare patient assistance program to purchase Gelmix and Purathick at a discounted rate to ensure greater accessibility. Click here to learn more.
FAVORABLE FOR COVERAGE: PHARMACY BENEFIT
Gelmix and Purathick are favorable for coverage as over-the-counter (OTC) products with a prescription under the pharmacy benefit.
Click to Search Available Pharmacies
REQUIREMENTS
–Prescription required
–Prior Authorization required (must include quantity, day supply, diagnosis; refer to the resources below for full PA requirements)
PRODUCT NDC CODES
-Gelmix Infant Thickener (125g Jar): 55764-0007-02
-Gelmix Infant Thickener (2.4g Sticks): 55764-0007-11
-Purathick Natural Thickener (125g Jar): 55764-0007-03
-Purathick Natural Thickener (2.4g Sticks): 55764-0007-09
RESOURCES/LINKS
Nutritionals Prior Authorization Form
Department of Vermont Health Access OTC Drug List
Favorable for Coverage by Medicaid. This state provides favorable Medicaid coverage for thickeners through DME reimbursement code B4100, utilizing cost-plus reimbursement rates. Gelmix and Purathick are typically covered.
Submit Referral and Request Services
866-883-1188
Edgepark is a division of Cardinal Health with direct shipment to your home. Pricing is determined once insurance and patient information has been entered during checkout.
Physician’s Written Order Form
my.edgepark.com
1-888-394-5375
Gelmix Jar: PPTGELWHO004
Purathick Jar: PPTPURWHO001N
Medicaid Coverage Needs Improvement. This state currently provides coverage for thickeners through DME reimbursement code B4100 (or B4100-U1). However, the reimbursement rate may be too low or is currently unclear, which can make it challenging for suppliers to offer low-weight, gum-based thickeners like Gelmix and Purathick. Advocating for updates to the Medicaid reimbursement schedule to a cost-plus model could ensure better access to these essential products. Medicaid recipients qualify for our WeCare patient assistance program to purchase Gelmix and Purathick at a discounted rate to ensure greater accessibility. Click here to learn more.
3333 South 120th Place
Suite 100
Tukwila, WA 98168
ph: 800-832-0319
fx: 425-687-4401
Not Covered by Medicaid. Currently, this state does not provide Medicaid coverage for thickeners, as they are not typically classified as a medical necessity. While no thickeners are covered at this time, advocacy efforts can help bring attention to the importance of these products for individuals with specific dietary needs. Medicaid recipients qualify for our WeCare patient assistance program to purchase Gelmix and Purathick at a discounted rate to ensure greater accessibility, Click here to learn more.
Favorable for Coverage: Pharmacy Benefit (OTC)
Gelmix and Purathick are favorable for coverage as over-the-counter (OTC) products with a prescription under the pharmacy benefit.
Click to Search Available Pharmacies
Requirements
-Prescription required
Product NDC Codes in WY
-Gelmix Infant Thickener (125g Jar_: 55764-0007-02
-Gelmix Infant Thickener (2.4g Sticks): 55764-0007-11
-Purathick Natural Thickener (125g Jar): 55764-0007-03
-Purathick Natural Thickener (2.4g Sticks): 55764-0007-09
Resources / Links
Wyoming Medicaid Pharmacy Provider Manual