Provider Manual

 
 

Nutrition counseling/education/therapy billing

The benefit limit is 6 visits per contract year for medical nutrition therapy, nutrition education, and nutrition counseling, combined.

No authorization is required for participating providers. However, PCP referral is encouraged.

Services may be reported with a valid CPT code by:

  • Participating hospitals/facilities: Report with revenue code 0942 on the UB04.
  • Registered dietitians should bill under the supervising physician in the provider office setting: Report with the AE modifier.
  • Health departments

Units billed should total the time spent. Example: For 30-minute visits, bill 2 units.

Codes accepted:

Covered for fully funded, self-funded, MyPriority®, Medicare and Priority Health Choice (Healthy Michigan Plan and Medicaid) members.

  • 97802: Initial one-on-one with the patient, 15 minutes
  • 97803: Follow-up one-on-one with the patient, 15 minutes
  • 97804: Group session, 30 minutes or more
  • G0270: Reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face-to-face with the patient, each 15 minutes
  • G0271: Reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes

Last modified: 9/13/2016
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