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Reimbursement Policy to be Implemented: Medical Nutrition Therapy (MNT)

Effective April 15, 2021, we will change how we consider and reimburse certain claims for Medical Nutrition Therapy based on our new reimbursement policy guidelines, Medical Nutrition Therapy (MNT).

MNT services represented by the procedure codes in the table below when submitted on claims for services provided on and after April 15, 2021 will only be considered for reimbursement if billed by a:

  • Registered dietician
  • Nutritional professional
  • Hospital that has received assignment from a registered dietician or nutritionist

MNT services will not be considered for reimbursement when billed by a provider other than those listed above or when billed “incident to” physician services.

Code

Description

97802

MNT, initial assessment and intervention, individual, each 15 minutes

97803

MNT, reassessment and intervention, individual, each 15 minutes

97804

MNT, group, each 30 minutes

G0270

MNT, reassessment and subsequent intervention following second referral in same year for change in diagnosis, medical condition or treatment regimen, individual, each 15 minutes

G0271

MNT, reassessment and subsequent intervention following second referral in same year for change in diagnosis, medical condition or treatment regimen, group, each 30 minutes

Claims for MNT services will also be processed based on the following policy guidelines.

  • Only one MNT service will be considered for reimbursement per date of service.
  • 97802 may only be submitted once for the initial assessment of a new patient. Subsequent visits should be billed using 97803 or 97804.
  • 97803 will be considered up to a maximum of 11 units per calendar year.
  • 97802, 97803, 97804 will be considered up to a combined maximum of 12 units per calendar year.

We encourage you to review the content of our Medical Nutrition Therapy (MNT) reimbursement policy,

CPT® is a registered mark of the American Medical Association.

Published on: January 14, 2021, 02:26 a.m. ET
Last updated on: January 13, 2021, 02:29 a.m. ET