SimplePractice MNT Billing: What Works and What Doesn't
Billing 97802 and 97803 in SimplePractice: unit setup, referral and telehealth fields, the Oct 1, 2026 claim fees, and where dietitians still do it by hand.
By Javier Alvarez · Published · 6 min read
Disclosure: Farela competes with SimplePractice for some dietitians, and we wrote this. SimplePractice facts come from its own pricing page and support articles, checked September 28, 2026. For the broader product review, see our SimplePractice review for dietitians. This page is only about billing medical nutrition therapy through it.
A 60-minute follow-up goes out as one unit of 97803. Nobody typed a wrong number. The service was set to bill in units, the unit count stayed at its default of 1, and the claim went out clean, got paid, and underpaid you for three quarters of the visit. You find out when you compare the ERA with your calendar, if you ever do.
That's the shape of MNT billing in SimplePractice. The pipeline is solid. What goes into it is on you. Here's what works, what doesn't, and what changed on October 1, 2026.
What changed on October 1, 2026
SimplePractice announced new insurance pricing in a support article. Subscription prices stay the same, but claims now cost the same on every plan:
| Plan | Starting per-claim rate before Oct 1 | From Oct 1, 2026 |
|---|---|---|
| Starter ($49/mo) | $0.50 | $0.39 |
| Essential ($79/mo) | $0.35, plus some free claims | $0.39, no free claims |
| Plus ($99/mo) | $0.25, plus some free claims | $0.39, no free claims |
Volume pricing drops the rate to $0.37 from claim 251, $0.35 from claim 601 and $0.33 after 1,000 in a month. Manual insurance status (eligibility) checks cost $0.15 each on Starter and Essential. Plus keeps them free through March 31, 2027, then pays $0.15 too. There's also a new optional tier, Insurance Navigator, at $1.79 per claim, which adds benefits verification, an AI claim assistant, EOB upload and phone access to insurance specialists. The pricing page also lists a $20 annual fee per clinician for AMA CPT codes.
For a solo RD sending 40 claims a month on Essential, that's $79 plus about $15.60 in claim fees, plus $0.15 for each eligibility check. On Navigator, the same 40 claims cost $71.60 in claim fees.
Setting up MNT correctly in SimplePractice
1. Make 97802 and 97803 unit-billed services
MNT codes are time-based: 97802 and 97803 are billed per 15 minutes. In SimplePractice, open Settings > Services and products > Services, check Bill in units, and set a rate per unit. According to the unit billing guide, the default is 1 unit, and the unit count does not change when the appointment is longer. You set the units on every appointment yourself.
Count them from documented face-to-face minutes: 1 unit from 8 minutes, 2 from 23, 3 from 38, 4 from 53. Our MNT units calculator shows the full table. SimplePractice also recommends editing the appointment and recreating the claim if details change after the claim exists, so fix the units on the appointment, not only on the claim.
2. Point the right diagnosis at the right line
The claim carries up to 12 ICD-10 codes and each service line points to them. Two MNT rules the software won't enforce:
- Z68 BMI codes are never primary. Put the weight diagnosis (for example an E66 code) first and the Z68 code after it.
- Z71.3 changes the benefit. Some plans pay dietary counseling under the preventive benefit with Z71.3 plus a risk code, others want a medical diagnosis first. Our preventive vs medical benefits guide explains the routing.
3. Telehealth: POS and modifier by payer
For video visits, the place of service is usually 10 (patient at home) or 02 (patient somewhere else), per the CMS POS code set, and some commercial plans also want modifier 95. Enable modifiers in SimplePractice and set them per appointment. A wrong POS is one of the most common reasons a telehealth nutrition claim bounces. See telehealth billing for dietitians.
4. Medicare: the referral belongs on the claim
Medicare pays RD-provided MNT only with a referral from a treating MD or DO, for diabetes, non-dialysis kidney disease or a recent kidney transplant, with 3 hours in the first calendar year and 2 after (42 CFR 410.130-410.134). The referring physician's name and NPI go in boxes 17 and 17b. SimplePractice has a Referring provider field in a client's billing settings under "Show additional claim fields". Fill it before the first Medicare claim, and track the hours yourself.
What works, what doesn't
| Task | In SimplePractice | Who does the MNT-specific part |
|---|---|---|
| Electronic claim submission | Works well, primary and secondary | Software |
| Claim status and rejections | Billing hub, corrected-claim workflow | You read and fix them |
| ERAs | No-fee enrollment; ERAs post payments and update claim status | You reconcile what the client owes |
| Units for 97802/97803 | Unit billing, default 1 | You, every visit |
| Diagnosis order and pointers | Pre-submission check flags a missing diagnosis, not a wrong order | You |
| Nutrition benefit limits | Status checks framed for mental health coverage | You call the payer |
| Medicare MNT referral and hours | Referring provider field | You track hours and renewals |
| MNT note (ADIME, PES) | Templates you build | You, or a separate scribe |
| AI notes | Note Taker add-on, $35/mo, generates progress notes | You adapt them to MNT |
The pattern is consistent: the software does the transmission well. Everything nutrition-specific, before the claim exists and after the payer answers, stays with you.
Where it falls short for MNT
- Benefits checks are framed for therapy. SimplePractice's Insurance Essentials guide says its insurance status checks help verify a client's mental health coverage, and Navigator's verification is described the same way. Nutrition benefits (visit caps, preventive versus medical, referral rules) usually need a call. Our benefits verification checklist lists the 12 questions.
- Nothing links the note to the units. Pre-submission checks flag a missing diagnosis, CPT code, location or demographic field. They don't compare the claim's units with the minutes in your note.
- Charting is still yours. Note Taker generates progress notes; an ADIME note with a real PES statement is still something you shape by hand.
- Costs now scale per claim. Not a problem by itself, but budget for it: claims, eligibility checks, the CPT fee and add-ons all add up.
Who should stay on SimplePractice
- Practices where RDs share the system with therapists or other clinicians.
- RDs who already bill MNT cleanly and want dependable submission and a polished client portal.
- Practices that need group appointments, ePrescribe or a mature mobile app.
Where Farela fits, and where it doesn't
Farela is built for the part this page keeps handing back to you. It records the visit (video in Farela, in person or by phone), writes the structured MNT note with a PES statement and units counted from the visit time, and drafts the claim: CPT, ICD-10 with pointers, modifiers and POS. You review it and submit through your own Claim.MD account. Eligibility checks run through Claim.MD, payments are tracked from the ERA, and cash visits are invoiced through Stripe. The EHR is free, with 20 transcription hours a month; billing is 3.9% of what insurers pay, and you pay Claim.MD directly.
It is not the right move if you need a client portal, group scheduling with therapists, or ePrescribe, or if you bill high volumes where a flat per-claim fee costs less than a percentage. We ran those numbers in best billing software for dietitians.
Sources
- SimplePractice — What's changing with insurance pricing (Oct 1, 2026)
- SimplePractice — Insurance Essentials (features, status checks, ERAs)
- SimplePractice — Using unit billing
- SimplePractice — Pricing (checked Sep 28, 2026)
- CMS Medicare Claims Processing Manual, Ch. 4, §300 (Medical Nutrition Therapy)
- 42 CFR 410.130-410.134 (MNT definitions and referrals)
- CMS — Place of Service code set
- NUCC — 1500 Claim Form instructions
Sources checked . Payer rules change; verify the member's benefits.
Frequently asked questions
How do I bill 97803 in units in SimplePractice?
Turn on Bill in units for the service in Settings > Services and products > Services and enter a rate per unit. SimplePractice's unit billing guide says the default is 1 unit and the units don't change with the appointment's length, so you set the units on each appointment from the documented face-to-face minutes. The units then fill box 24G on the claim.
How much does SimplePractice charge per insurance claim?
From October 1, 2026, SimplePractice says electronic claims start at $0.39 each on every plan, with lower rates above 250 claims a month, and the free monthly claims on the Essential and Plus plans end. Manual insurance status checks cost $0.15 each on Starter and Essential. Its optional Insurance Navigator tier is $1.79 per claim. Check the support article for current rates.
Can SimplePractice verify nutrition benefits for me?
Not really. SimplePractice describes its insurance status checks as a way to verify a client's mental health coverage, and says the result depends on what the payer returns. The benefits verification in its Insurance Navigator tier is described the same way. For MNT, you still confirm visit limits, preventive versus medical benefit and referral rules with the payer.
Is SimplePractice good for dietitians who bill Medicare?
It can submit Medicare claims, but Medicare MNT rules are yours to apply: a referral from an MD or DO, qualifying diagnoses (diabetes, non-dialysis kidney disease or a kidney transplant in the last 36 months), and the yearly hour limits. The software won't warn you when a visit falls outside them.
Should a dietitian switch away from SimplePractice?
Not if you share the system with therapists or other clinicians, or if you already bill MNT cleanly and just want reliable submission. Consider an alternative if you're a solo, insurance-heavy RD and the note, the units and the claim are what eat your evenings.
Part of Software & workflow. Start with Best Practice Management Software for Dietitians (2026).