If you have a medical nutrition therapy private practice, accepting insurance is a great way to make it easier for your patients to access your services. Insurance requirements may feel confusing but, luckily, there are a few common CPT codes that are specific to nutritionists and dietitians. If you’re familiar with just 97802, 97803, 97804, G0270 and G0271, you’ll be able to help your patients get the most out of their coverage, and make your billing process simpler than ever before. Simplify the process even further with an all-in-one practice management system like Healthie. Click here to learn more!
What CPT codes do nutritionists need to know?
CPT codes indicate the type of service you provided for a patient to an insurance provider. There are thousands of codes, but there are three main ones for nutritionists to keep in mind. Both private and public providers will recognize the following CPT codes:
- 97802; this code covers your first face-to-face visit with a patient. It can be used only once a year, and only for the initial assessment of a new patient.
- 97803; this code covers any follow-up visits or reassessments with an individual patient.
- 97804; this code covers any follow-up visits or reassessments with a patient in a group setting (two or more individuals).
Each code represents a 15 minute block of time, and most insurance companies place a limit on how much time they cover in a year. For instance, Medicare covers 3 hours (12 15-minute units) of sessions in a patient’s first year of nutrition counseling, and 2 hours (8 units) in each following year.
Many nutritionists split the time across short appointments so that their patients can check in with them more often. This is one effective way to help your clients make the most of their insurance coverage, but you may also be able to utilize codes G0270 and G0271.
What is CPT code G0270?
In 2003, two G codes were specifically created for medical nutritional therapy. These can be used to bill for additional time, as long as there’s been a change in the patient’s condition. They are:
- G0270; this code covers 15-minute face-to-face sessions for reassessment and interventions after a patient’s second referral in the same year for a change in their diagnosis, condition or treatment regimen.
- G0271; this code has similar criteria to G0270, but covers a 30-minute group session for reassessment and interventions.
How can CPT code G0270 be used in a nutrition practice?
The two G CPT codes, G0270 and G0271, mean that if your patient’s health status changes in some way that impacts their nutrition, you can be reimbursed for an additional 120 minutes of time with them, even if they’ve used up all their benefits for the calendar year.
Once your patient has used up all their coverage, including G code coverage, you could either recommend that they self-pay until the end of the calendar year, or simply wait until the year is up. In the new year, their coverage will reset, and insurance will cover their nutrition counseling again.
Being knowledgeable about CPT code G0270 and the other key medical nutrition therapy CPT codes means that you can help your patients get as much of their care covered as possible. This is a great way to ensure that you’re providing an affordable service to your clients. Keeping up with all of these codes and regulations doesn’t have to be difficult with Healthie’s all-in-one practice management software. Simply click here to get started with a free plan today.
Key Things to Remember about Insurance Billing
- Insurance billing is measured in 15 minute blocks of time. For instance, a 1 hour appointment is 4 units. When you fill out a CMS 1500 form, specify the number of units and the fee per unit.
- You don’t need to change your CPT codes for telehealth appointments, as the type of service remains the same.
- If you’re billing with Medicare, remember to only bill for time spent in the session. Anything like reading charts or creating meal plans is not considered billable time. You may wish to create an add-on service to account for this.
- If you’re billing for obesity treatment through Medicaid, make sure to check with your state reimbursement representative to confirm coverage, as this varies significantly between states.
Insurance Billing with Healthie
There’s a lot to remember when it comes to billing for medical nutrition therapy, but Healthie makes it easy. Healthie is a HIPAA-compliant all-in-one practice management and EHR platform for nutrition and wellness professionals, streamlining insurance-based and self-pay billing for your services. Our free starter plan includes all of this and more. With Healthie, you can:
- Provide clients with a login so they can securely message you, complete paperwork electronically, send you photos and documents, and even keep a photo-based food journal
- Use and customize nutrition charting templates
- Create invoices and process client payments for self-pay services
- Create and send superbills and CMS 1500 claims
- Record and store a client’s insurance information
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