S9432 Med food non inborn err metaMedical foods for non-inborn errors of metabolism
Status I: not valid for Medicare (Medicare uses another code).
16 of 16 payer prior-auth lists that name S9432 require prior authorization or set conditions: Molina Complete Care (Virginia), Molina Healthcare of California, Molina Healthcare of Idaho, Molina Healthcare of Illinois, Molina Healthcare of Iowa, Molina Healthcare of Michigan, Molina Healthcare of Mississippi, Molina Healthcare of Nevada, Molina Healthcare of New Mexico, Molina Healthcare of Ohio, Molina Healthcare of Texas, Passport by Molina Healthcare (Kentucky).
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Molina Complete Care (Virginia) | Medicaid | VA | prior auth required | Apr 1, 2025 | Virginia Medicaid PA Code Matrix and Virginia code/benefit exceptions, effective Q2 2025 | |
| Molina Healthcare of California | Medicaid | CA | prior auth required | Apr 1, 2026 | Medicaid Prior Auth (PA) Code Matrix (California), effective Q2 2026 | |
| Molina Healthcare of Idaho | Medicaid | ID | prior auth required | Jan 1, 2025 | Idaho Medicaid Prior Auth (PA) Code Matrix and Idaho code/benefit exceptions, Q1 2025 | |
| Molina Healthcare of Illinois | Medicaid | IL | prior auth required | Jan 1, 2022 | Molina Healthcare of Illinois Codification Grid Q3 2026 | |
| Molina Healthcare of Iowa | Medicaid | IA | prior auth required | Jul 1, 2023 | IA Prior Authorization Matrix, effective Q3 2023 | |
| Molina Healthcare of Michigan | Medicaid | MI | prior auth required | Jul 1, 2026 | Molina Healthcare of Michigan PA Matrix 2026-Q3 | |
| Molina Healthcare of Mississippi | Medicaid | MS | prior auth required | Jan 1, 2025 | Mississippi Medicaid Prior Auth (PA) Code Matrix and exceptions, effective Q1 2025 | |
| Molina Healthcare of Nevada | Medicaid | NV | prior auth required | Oct 1, 2022 | Medicaid Prior Auth (PA) Code Matrix, effective Q4 2022 | |
| Molina Healthcare of New Mexico | Medicaid | NM | prior auth required | Jul 1, 2026 | New Mexico Medicaid Prior Auth (PA) Code Matrix, effective July 1, 2026 | |
| Molina Healthcare of Ohio | Medicaid and MyCare Ohio (MMP) Medicaid | OH | prior auth required | Oct 1, 2023 | Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01 | |
| Molina Healthcare of Ohio | Medicare and MyCare Ohio (MMP) Medicare | OH | prior auth required | Oct 1, 2023 | Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01 | |
| Molina Healthcare of Ohio | Exchange | OH | prior auth required | Oct 1, 2023 | Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01 | |
| Molina Healthcare of Texas | STAR | TX | prior auth required | Feb 19, 2025 | Molina Healthcare of Texas Prior Authorization Annual Review Report (STAR), reviewed 2025-02-19 | |
| Molina Healthcare of Texas | STAR+PLUS | TX | prior auth required | Feb 19, 2025 | Molina Healthcare of Texas Prior Authorization Annual Review Report (STAR+PLUS), reviewed 2025-02-19 | |
| Molina Healthcare of Texas | STAR, STAR+PLUS, STAR Kids, CHIP (Medicaid PA code matrix) | TX | prior auth required | Jan 1, 2022 | Medicaid Behavioral Health and Medical Prior Authorization (PA) Code Matrix (Texas), 2026-Q3 | |
| Passport by Molina Healthcare (Kentucky) | Medicaid | KY | prior auth required | Jul 1, 2026 | Kentucky Medicaid Prior Auth (PA) Code Matrix and Kentucky PA Code Exceptions, effective Q3 2026 |
S9432 appears in 14 coverage policies from Aetna, Anthem, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross, Regence, UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Nutritional Support (0061) | listed, no stance | Jan 15, 2026 | payer document |
| Anthem | Home Enteral Nutrition (CG-MED-08) | covered if criteria are met | Aug 13, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Nutritional Support (MED201.011) HCPCS Codes B4034, B4035, B4036, B4081, B4082, B4083, B4087, B4088, B4102, | listed, no stance | Jan 1, 2026 | payer document |
| Premera Blue Cross | Non-covered Services and Procedures Page | 19 of 30 | ∞ | not covered | Jun 1, 2026 | payer document |
| Regence | Enteral and Oral Nutrition Therapy in the Home Setting (Allied Health 05) | listed, no stance | Mar 1, 2026 | payer document |
| UnitedHealthcare | Enteral Nutrition (Oral and Tube Feeding) (CS136.R) Metabolic and Specialized Foods | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Enteral Nutrition (Oral and Tube Feeding) (MP.027.14) Metabolic and Specialized Foods | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Enteral Nutrition (Oral and Tube Feeding) (for Kansas Only) (CS136KS.03) Metabolic and Specialized Foods | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Enteral Nutrition (Oral and Tube Feeding) (for Kentucky Only) (CS136KY.13) Metabolic and Specialized Foods | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Enteral Nutrition (Oral and Tube Feeding) (for Nebraska Only) (CS136NE.O) Metabolic and Specialized Foods | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Enteral Nutrition (Oral and Tube Feeding) (for New Mexico Only) (CS136NM.D) Metabolic and Specialized Foods | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Enteral Nutrition (Oral and Tube Feeding) (for Ohio Only) (CS136OH.F) Metabolic and Specialized Foods | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Enteral Nutrition (Oral and Tube Feeding) (for Pennsylvania Only) (CS136PA.R) Metabolic and Specialized Foods | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Enteral Nutrition (Oral and Tube Feeding) (for Tennessee Only) (CS136TN.P) Metabolic and Specialized Foods | listed, no stance | Jun 1, 2026 | payer document |
Prior authorization required or conditional in CO, IN, OH, VA.
From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.