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Changes to billing procedures for nutrition counseling are now in effect
Professional
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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, nutrition counseling in a group setting is no longer eligible for
payment for dates of service on or after March 1, 2013. 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.