Guides · Billing guide

CPT 97802 vs 97803: when to bill each

By Javier Alvarez · Updated October 8, 2026 · 4 min read

This guide is for registered dietitians billing US insurance. Rules vary by payer and contract and change yearly; always check your payer's current policy. Each code also has its own reference page: 97802, 97803, 97804 and G0270/G0271. To check one visit (code, units, POS, modifier and diagnosis order), use the CPT code finder.

The MNT codes at a glance

97802: the first visit

Use 97802 when you see a patient for MNT for the first time: the full nutrition assessment, diagnosis and the first intervention. Most payers expect it once per patient. A few allow it again after a long gap or a new referral, but billing 97802 a second time is a common reason for a denial, so check the payer's policy first.

If the patient was already seen by another dietitian in your group, many payers still treat the next visit as a follow-up. When in doubt, bill 97803.

97803: every follow-up

Use 97803 for any individual visit after the initial assessment: progress review, re-assessment, plan changes and counseling. It is billed with the same 15-minute units. Most of your volume should be 97803.

15-minute units and the 8-minute rule

97802 and 97803 are 15-minute codes. Under CPT's time rule a unit counts once you pass its midpoint, so 8 minutes or more. The minute ranges below are the same ones Medicare publishes for 15-minute therapy codes (the "8-minute rule" in Chapter 5 of the Claims Processing Manual), and most payers apply them to MNT. CMS doesn't publish a separate rounding rule for MNT. Charting time after the patient leaves does not count.

Minutes to units (8-minute threshold)

97804 for groups

97804 is group MNT for 2 or more patients, and it is billed per 30 minutes, not 15. Each attendee gets their own claim. A 90-minute group class is 97804 × 3 on each patient's claim, if the payer covers group MNT. Medicare's group code after a second referral is G0271, also per 30 minutes.

G0270 and G0271 for Medicare

Original Medicare covers MNT for diabetes, chronic kidney disease not on dialysis, and the 36 months after a kidney transplant, on a referral from the treating physician. The basic benefit is 3 hours in the first calendar year and 2 hours each year after. Within that benefit you bill 97802, 97803 and 97804 as usual.

If the treating physician makes a second referral in the same calendar year because the diagnosis, medical condition or treatment regimen changed, the additional hours are billed with G0270 (individual) or G0271 (group). See Medicare MNT coverage for the full rule.

Telehealth: place of service and modifiers

97802, 97803, 97804 and G0270 are on Medicare's telehealth list, and registered dietitians are permanent Medicare telehealth practitioners. Most commercial plans also cover video MNT. What changes on the claim is the place of service (POS) and, for many payers, a modifier.

Since 2024, Medicare pays telehealth billed with POS 10 at the non-facility rate and relies mainly on POS to identify telehealth on professional claims. Many commercial payers want POS 10 or 02 and modifier 95, while some still want POS 11 with modifier 95. Congress has extended Medicare's telehealth flexibilities, including the patient's home as an originating site, through December 31, 2027; after that date, check the current rules before billing Medicare home telehealth. More in telehealth billing for dietitians.

What you get paid

Allowed amounts for 97802 and 97803 vary by payer, plan, contract, region and year, so we don't quote dollar figures. Medicare pays registered dietitians 85% of the Physician Fee Schedule amount; look it up for your locality in the CMS Physician Fee Schedule look-up tool. Commercial allowed amounts sit above or below Medicare depending on your contract; each payer's fee schedule is the only reliable number. Set your charge at or above your highest contracted rate so you are never paid less than the contract allows.

Worked example claim

A 50-minute initial video visit with a commercial patient at home, for type 2 diabetes with overweight.

CMS-1500 / 837P, service line

All data in this example is invented for illustration.