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Which codes does each payer pay a dietitian for? A code sheet by payer

The short answer. All six payers here pay 97802 for the first MNT visit and 97803 for follow-ups, per 15-minute unit. The rest of the claim varies by payer: Anthem and Cigna take Z71.3 and S9470 on preventive claims, UnitedHealthcare requires R73.03, a cardiovascular risk factor or a BMI code and replaces S9470, and on video Cigna uses POS 02 while UnitedHealthcare, Anthem, Highmark and Medicare use POS 10 for a patient at home. Medicare covers only diabetes and kidney disease and requires a referral.

By Javier Alvarez · Updated · 5 min read

First visit / follow-up97802 / 97803, per 15 minutes, at every payer on this sheet
S9470Listed by Aetna, Anthem and Cigna; replaced with 97802/97803 by UnitedHealthcare
Z71.3 as preventive diagnosisAnthem and Cigna list it; UnitedHealthcare's MNT rows and Aetna's CPB 0049 don't
Telehealth at homePOS 10 at UHC, Anthem, Highmark and Medicare; Cigna asks for POS 02 with 95, GT or GQ
Visit limits in public policyAetna 26 weight-loss visits a year (CPB 0039); Medicare 3 hours, then 2 a year; others plan-specific
Allowed amountsYour contract for commercial plans; Medicare 2026 national $31.23 (97802) and $26.97 (97803) per unit
Last verifiedOctober 22, 2026, every source opened that day

The MNT code sheets that circulate in dietitian groups are one PDF for every payer, with no dates and no sources. We made one sheet per payer instead, so you print only the page a claim needs. Every rule has the date we last opened the payer's own policy and the link to it, so you can check it yourself before a claim goes out. Where a rule depends on the state or the plan, it says so.

Six payers, side by side

Payer Codes Telehealth at home Visit limits in public policy
Aetna 97802 97803; S9470 listed No national policy. The Texas page asks for POS 02 and modifier 95 or GT 26 weight-reduction visits a year (CPB 0039)
UnitedHealthcare 97802 97803; S9470 replaced POS 02 or 10, live audio and video Plan-specific
Anthem Blue Cross Blue Shield 97802 97803; S9470 listed, Z71.3 first POS 02 or 10 with modifier 95 or GT Plan-specific
Cigna 97802 97803; S9470 listed, Z71.3 in Code Group 1 POS 02 with 95, GT or GQ; not POS 10 No public number: plan-specific
Highmark 97802 97803; one MNT code per date POS 10 at home, 02 elsewhere None in RP-076 or V-44-017
Medicare 97802 97803; referral required POS 02 or 10 with modifier 95 3 hours the first year, then 2 a year

Each payer's sheet has more: diagnoses, units, referral rules, allowed amounts and the policy link.

What each payer pays a dietitian for

What does Aetna pay a dietitian for?

97802 and 97803 per 15-minute unit at your contracted rate, for obesity, overweight with a cardiovascular risk factor, and chronic conditions where diet is part of treatment. Weight-reduction counseling for adults with a BMI of 30 or more is capped at 26 visits per 12 months.

Open the Aetna sheet, with the full table, the PDF and the sources.

What does UnitedHealthcare pay a dietitian for?

97802 to 97804 and G0270/G0271 on three preventive rows, each with its own diagnosis list. Z71.3 is not on those lists, and UnitedHealthcare replaces S9470 with 97802 or 97803.

Open the UnitedHealthcare sheet, with the full table, the PDF and the sources.

What do Blue Cross and Anthem pay a dietitian for?

each Blue plan sets its own rules, so there is no national BCBS answer. Anthem's commercial plans list 97802 to 97804, G0270, G0271 and S9470 as preventive, with Z71.3, Z72.3 or Z72.4 first and a BMI or obesity code second on the obesity rows.

Open the Anthem Blue Cross Blue Shield sheet, with the full table, the PDF and the sources.

What does Cigna pay a dietitian for?

97802, 97803, 97804 and S9470 as preventive when the diagnosis is a wellness code from Cigna's Code Group 1, which includes Z71.3. With an illness diagnosis the same visit is reviewed under the medical benefit. On video, Cigna asks for POS 02, not 10.

Open the Cigna sheet, with the full table, the PDF and the sources.

What does Highmark pay a dietitian for?

97802 once for a new patient, then 97803 (or 97804 for groups), billed by a registered dietitian or nutrition professional, one MNT code per date of service. On video, POS 10 for a patient at home and 02 elsewhere, paid at parity with in-person visits.

Open the Highmark sheet, with the full table, the PDF and the sources.

What does Medicare pay a dietitian for?

MNT for diabetes, kidney disease and a kidney transplant in the last 36 months, with a doctor's referral: 3 hours in the first calendar year and 2 a year after, more with a second referral (G0270). The patient pays nothing, and you are paid 85% of the fee schedule.

Open the Medicare sheet, with the full table, the PDF and the sources.

How many units does a visit bill?

Short answer: One unit per 15 minutes of face-to-face time, counted from 8 minutes. That is CMS's table for 15-minute timed codes, and the same midpoint rule CPT uses. A commercial contract can count units differently or cap them per visit, and the contract wins.

Face-to-face minutes 97802 / 97803 / G0270 units
Under 8 0 (not billable)
8 to 22 1
23 to 37 2
38 to 52 3
53 to 67 4
68 to 82 5

Group codes (97804, G0271) are per 30 minutes. The MNT units calculator does the arithmetic for any visit length. Source: CMS Claims Processing Manual, ch. 5 Section 20.2, verified October 22, 2026.

97803, 99404 or S9470: which one goes on the claim?

Short answer: 97803, unless the contract tells you otherwise.

Code What it is Who lists it
97803 MNT re-assessment and intervention, per 15 minutes All six payers on this sheet
99401 to 99404 Preventive medicine counseling, 15 to 60 minutes UHC, Anthem and Cigna on preventive rows; Aetna as a related code; Highmark's PA policy lists 99402 to 99404. Not a Medicare MNT code
S9470 Nutritional counseling, dietitian visit (per visit) Aetna, Anthem, Cigna. UHC replaces it with 97802/97803. Not a Medicare MNT code

If a contract pays 99404 or S9470 differently from 97803, that is a term of that contract, not a payer rule: check the fee schedule before you switch codes.

Why do telehealth MNT claims deny with CO-96?

Short answer: CO-96 is a non-covered charge, and the remark code (RARC) on the same line tells you why. Read it before you resubmit.

On telehealth claims, the causes we see in these policies are:

  1. The POS and modifier pair. Cigna asks for POS 02 with 95, GT or GQ; UHC, Anthem, Highmark and Medicare take POS 10 for a patient at home; Blue Cross of Rhode Island denies a telehealth modifier with any POS other than 02 or 10. A POS problem can also come back as CO-5, a modifier problem as CO-4.
  2. The code isn't on the payer's telehealth list. UHC pays the codes on its Telehealth Eligible Services list, Anthem the codes in CPT Appendix P, Highmark follows the CMS list.
  3. The plan excludes the service or the visit limit is used up. That is a benefits question, which the benefits check answers before the visit.

Source: X12 CARC list and the payer policies above, verified October 22, 2026. For the full list of denial codes, see the claim denial checker.

Duo builds the claim with these rules from the recorded visit, and you review it before it goes out. Try Duo Practice free

The insurance claim section of a visit in Duo Practice, with CPT 97802, diagnosis Z71.3, session minutes and units.
The claim for a test visit in Duo Practice: CPT 97802, Z71.3, and units worked out from the session's minutes. You check it against the chart and press Submit.

Sources

  1. Aetna: Clinical Policy Bulletin 0049, Nutritional Counseling (last reviewed 03/10/2026)
  2. Aetna: Clinical Policy Bulletin 0039, Weight Reduction Medications and Programs (26-visit limit)
  3. Aetna: Texas telemedicine policy (POS 02 and modifier 95 or GT)
  4. UnitedHealthcare: Preventive Care Services, MP.016.60, effective 10/01/2026 (PDF)
  5. UnitedHealthcare: Telehealth/Virtual Health Policy, Professional, 2026R0046A (PDF)
  6. UnitedHealthcare: Replacement Codes Policy, Professional, 2026R0128A (S9470 to 97802/97803, PDF)
  7. Anthem Blue Cross and Blue Shield: ACA preventive care coding guidelines, commercial, August 2026 (PDF)
  8. Anthem: Commercial Reimbursement Policy C-08002, Virtual Visits, approved 03/26/2026 (PDF)
  9. Blue Cross and Blue Shield of Rhode Island: telemedicine modifier claims edit, effective 9/1/2026
  10. Cigna: Administrative Policy A004, Preventive Care Services, effective 10/1/2026 (PDF)
  11. Cigna: Virtual care billing guidance for commercial plans (updated 08/23/2022)
  12. Highmark: Reimbursement Policy RP-076, Medical Nutrition Therapy (effective 05/05/2025, PDF)
  13. Highmark: Reimbursement Policy RP-046, Telemedicine and Telehealth Services (version effective 09/01/2026, PDF)
  14. Highmark: Commercial Medical Policy V-44-017, Medical Nutrition Management Services (Pennsylvania)
  15. Medicare.gov: Medical nutrition therapy services
  16. CMS: Medicare Claims Processing Manual, Chapter 4, Section 300 (MNT codes, G0270/G0271, PDF)
  17. CMS: Medicare Claims Processing Manual, Chapter 5, Section 20.2 (minutes to 15-minute units, PDF)
  18. CMS: Change Request 13582 (POS 02 or 10 paired with modifier 95 or 93, PDF)
  19. CMS: Telehealth FAQ, updated 10/8/2026 (home telehealth through Dec 31, 2027, PDF)
  20. CMS MLN901705: Telehealth & Remote Patient Monitoring, December 2025 (PDF)
  21. CMS: PFS Relative Value Files, RVU26D (the Medicare amounts on this page)
  22. X12: Claim Adjustment Reason Codes (CARC 4, 5, 96)

Sources checked . Payer rules change; verify the member's benefits.

Frequently asked questions

Should I bill 97803, 99404 or S9470 for a follow-up?

97803 at all six payers on this sheet, by time. 99401 to 99404 are preventive counseling codes that UnitedHealthcare, Anthem and Cigna list on their preventive rows and Aetna lists as related codes, but Medicare doesn't pay them to dietitians. S9470 is a per-visit dietitian code: Aetna, Anthem and Cigna list it, UnitedHealthcare replaces it with 97802 or 97803, and Medicare doesn't list it. Use 99401 to 99404 or S9470 only when the contract or the plan asks for them.

Why did a telehealth MNT claim deny with CO-96?

CARC 96 means a non-covered charge, and the remark code next to it says why. On telehealth claims, the usual causes are a wrong POS and modifier pair for that payer (Cigna asks for POS 02, not 10; Blue Cross of Rhode Island denies 95 or GT with any POS other than 02 or 10 since September 1, 2026), a code not on the payer's telehealth list, or a plan that excludes the service. A POS mismatch can also come back as CO-5, a modifier mismatch as CO-4.

Does this sheet replace checking benefits?

No. This sheet shows public payer policies, not member benefits. The member's plan decides coverage, visit limits, referral requirements and cost sharing. Plans differ by state and employer. Run the benefits check before the first visit.

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