Billing codes · CPT code
CPT 97804: group medical nutrition therapy
By Javier Alvarez · Updated · 4 min read
| Code | 97804 (CPT, Category I) |
|---|---|
| What it covers | Group MNT, 2 or more individuals |
| Unit length | 30 minutes, per participant |
| Claims | One claim per patient, with their own diagnosis and units |
| Medicare status (2026 PFS) | A (active); on the Medicare telehealth list |
| Medicare MUE | 6 units per day (practitioner table effective Oct 1, 2026) |
| Medicare hours | Group time counts toward the same 3-hour / 2-hour MNT allowance |
| Medicare after a second referral | G0271 (group, 30 minutes) |
97804 is the only CPT code for MNT delivered to more than one patient at a time. Two things make it different from 97802 and 97803: the unit is 30 minutes, not 15, and a group session produces one claim per attendee, never one claim for the group.
If you're deciding whether groups are worth running, start with the business case for group MNT. This page is the billing reference.
What 97804 means
CPT describes 97804 as medical nutrition therapy, group (2 or more individual(s)), each 30 minutes. On the claim that means:
- Two or more patients receiving MNT together. They don't all need the same insurance, but every attendee you bill needs their own coverage for 97804.
- Each 30 minutes. Units come from each participant's attended time.
- Per participant. Each attendee gets their own claim line with 97804, their own diagnosis, their own units and their own place of service.
For Medicare, the claims manual says to bill 97804 for group visits, "initial and subsequent," including when a change in the patient's condition is addressed in a group (ch. 4, §300.4). There's no separate initial group code.
Units: 30 minutes, per participant
With the midpoint rule applied to a 30-minute unit, the thresholds shift:
| Minutes the participant attended | 97804 units |
|---|---|
| 0–15 | 0 |
| 16–45 | 1 |
| 46–75 | 2 |
| 76–105 | 3 |
| 106–135 | 4 |
Count units per person. If a 90-minute class starts with eight people and one leaves after 40 minutes, seven claims show 3 units and one shows 1 unit.
Medicare's practitioner MUE for 97804 is 6 units per day per patient (table effective October 1, 2026, adjudication indicator 2). Six 30-minute units is 3 hours, the whole first-year MNT allowance.
Group size and who can attend
- Minimum: two patients. If only one shows up, it isn't a group visit. Many billers then report individual MNT by time (97803), but confirm how the payer wants it before you assume.
- Maximum: CPT doesn't set one, and Medicare's MNT rules allow services "on an individual or group basis without restrictions" (§300.1). The 2-to-20 group size you may have seen comes from Medicare's diabetes self-management training rules, not MNT. See G0108/G0109.
- Mixed payers: a group can include Medicare, commercial and self-pay patients. Bill each one according to their own coverage.
Medicare hours and group time
Group time draws from the same MNT allowance as individual visits: 3 hours in the first calendar year and 2 hours each year after, with a physician referral (NCD 180.1). A 60-minute class (2 units of 97804) uses 1 hour. A patient who had a 60-minute 97802 initial and then attends two 60-minute classes has used the full 3 hours for the year.
When the physician refers again during the year for a change in diagnosis, condition or treatment, extra group time is billed as G0271, the group version of G0270. Here's the whole split:
| Situation (Medicare) | Code |
|---|---|
| Group MNT within the year's covered hours | 97804 |
| Group MNT after a second referral for a change in condition | G0271 |
| Individual MNT after a second referral | G0270 |
Documentation for each participant
The group is shared; the record isn't. Each participant's note needs:
- Date, session topic and that patient's attended time (start and stop)
- The diagnosis and, for Medicare, the referral on file
- Individual observations: questions asked, understanding, relevant self-reported data
- An individual goal or plan, even a short one
Identical notes with names swapped are an audit risk. Template the curriculum block and write the individual part for real. Consent for recording, if you record, is per person.
Coverage caveats by payer
- Medicare: covers group MNT under the same diagnosis, referral and hours rules as individual MNT. 97804 is on the 2026 telehealth list; G0271 isn't.
- Aetna: CPB 0049 lists 97804 among its nutritional counseling codes. Whether a given member's plan covers it is a benefits question.
- UnitedHealthcare: the Preventive Care Services policy lists 97804 with 97802/97803 in its preventive counseling rows, each with its own diagnosis requirements.
- Everyone else: a plan that covers 97802/97803 may still exclude 97804, or apply a separate limit. Verify 97804 by code for every participant. "Nutrition counseling is covered" isn't enough.
Group programs built around GLP-1 support or prediabetes are popular right now. See GLP-1 nutrition billing for how those visits are coded.
Common 97804 denials and the fix
| Problem | Fix |
|---|---|
| Units counted as 15-minute units (a 60-minute class billed as 4 units) | 97804 units are 30 minutes: bill 2 |
| One claim for the whole group | One claim per attendee |
| Group billed with a single attendee | Check the payer's rule; often bill individual MNT by time |
| Participant's plan excludes 97804 | Verify before the series; offer a self-pay rate in writing |
| Medicare hours already used | Second referral for a change in condition, then G0271 |
| Telehealth G0271 billed to Medicare | G0271 isn't on the 2026 telehealth list; review before billing |
Example (invented)
A 6-week prediabetes series meets by video for 60 minutes. In week 3, five participants attend the full hour, and one joins 25 minutes late (35 minutes attended).
- Five claims: 97804 × 2 units, each with the participant's own diagnosis (for example R73.03), POS 10
- One claim: 97804 × 1 unit (35 minutes falls in 16–45)
- Six individual notes, each with that person's attended time