CMS Pub. 100-04, ch. 4, § 300.4

The contractor shall pay for MNT services under the physician fee schedule for dates of

service on or after January 1, 2002, to a registered dietitian or nutrition professional that

meets the above requirements. Deductible and coinsurance apply. As with the DSMT benefit,

payment is only made for MNT services actually attended by the beneficiary and documented

by the provider, and for beneficiaries that are not inpatients of a hospital or skilled nursing

facility.

The contractor shall pay the lesser of the actual charge, or 85% of the physician fee

schedule amount when rendered by a registered dietitian or nutrition professional. As

required by statute, use this same methodology for services provided in the hospital

outpatient department.

A. Payable Codes for MNT with Applicable Instructions

• 97802 - Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes. (NOTE: This HCPCS code must only be used

for the initial visit.)

This code is to be used only once for the initial assessment of a new patient. The provider

shall bill all subsequent individual visits (including reassessments and interventions) as

97803. The provider shall bill all subsequent group visits as 97804.

• 97803 - Re-assessment and intervention, individual, face-to-face with the patient, each

15 minutes

The provider shall bill this code for all reassessments and all interventions after the initial

visit (see 97802). This code should also be used when there is a change in the patient’s

medical condition that affects the nutritional status of the patient (see the heading,

Additional Covered Hours for Reassessments and Interventions).

• 97804 - Group (2 or more individual(s)), each 30 minutes

The provider shall bill this code for group visits, initial and subsequent. This code can

also be used when there is a change in a patient’s condition that affects the nutritional

status of the patient and the patient is attending in a group.

NOTE: The above codes can be paid if submitted by a registered dietitian or nutrition

professional who meet the specified requirements; or a hospital that has received

reassigned benefits from a registered dietitian or nutritionist. These services cannot be

paid “incident to” physician services.

B. Healthcare Common Procedure Coding System (HCPCS) Codes for MNT When

There is a Change in the Beneficiaries Condition (for services effective on or after

January 1, 2003)

The following HCPCS codes shall be used when there is a change in the beneficiary's

condition:

• G0270 - Medical Nutrition Therapy; 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 - Medical Nutrition Therapy; 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.

NOTE: These G codes should be used when additional hours of MNT services are

performed beyond the number of hours typically covered, (3 hours in the initial calendar

year, and 2 follow-up hours in subsequent years with a physician referral) when the

physician determines there is a change of diagnosis or medical condition that makes a

change in diet necessary. Appropriate medical review for this provision should only be

done on a post payment basis. Outliers may be judged against nationally accepted dietary

or nutritional protocols in accordance with 42 CFR 410.132(a).