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.