As previously communicated,
most commercial managed care members are eligible for up to six fully covered
one-on-one nutrition counseling sessions with a registered dietitian or primary
care provider per benefit contract year. In the original communication about
this benefit in the June 2007 edition of Partners in Health
UpdateSM, group counseling sessions were mistakenly included in
the eligible list of codes. This benefit, however, was intended only to be
provided in an individual setting – not in a group setting.
Therefore, effective March 1,
2013, nutrition counseling in a group setting will no longer be eligible
for payment. Providers should no longer bill for medical nutrition therapy in a
group setting with the following codes: 97804, G0271. Only diabetic education
services are eligible for payment in a group setting with these codes.
Note: Members do not need to
obtain a referral for nutrition counseling services.