AmeriHealth Caritas Ohio MNT coverage: codes and limits
The short answerAmeriHealth Caritas Ohio will consider reimbursement of MNT billed by a registered dietitian or nutrition professional with a covered diagnosis and within the allowed frequency. Use 97802 once, then 97803 or 97804. Only one MNT code per date of service.
By Javier Alvarez · Updated · 1 min read
1 row: AmeriHealth Caritas · Ohio. Public policy, not the member's benefits.
AmeriHealth Caritas Ohio
Medicaid (AmeriHealth Caritas Ohio reimbursement policy) · Ohio
| 97802 | Listed (once, for the initial assessment of a new patient.) [1] |
|---|---|
| 97803 | Listed (individual follow-up visits.) [1] |
| G0270 | Listed (listed in the policy's code table.) [1] |
| G0271 | Listed (listed in the policy's code table.) [1] |
| Where it applies | Reimbursement policy RPC.0121.7700, reviewed 03/2026, for claims on CMS-1500 or UB-04. FQHCs may not submit claims for group settings. [1] |
| Diagnoses | Services must be reported with a covered diagnosis. The policy defines MNT as help to manage diabetes, kidney disease, or other nutrition related diagnoses. [1] |
| Other codes | The code table also lists 97804, G2025 (RHC/FQHC telehealth distant site, insulin injection training), S9470 (nutritional counseling, dietitian visit) and S9452 (nutrition classes). [1] |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | Not published: call the payer. |
| Visit limits | 97802 is used once for a new patient and all later visits use 97803 (individual) or 97804 (group). Only one MNT procedure code may be billed per date of service, regardless of modifier. [1] |
| Referral and prior auth | Not published: call the payer. |
| Who can bill | Services must be rendered by a registered dietitian or nutrition professional. MNT is covered only when rendered by professionals credentialed as registered dietitians or licensed nutritionists. [1] |
| Also | The policy cites Ohio Administrative Code 5160-8-41 and 5160-8-53, the AmeriHealth Caritas Ohio provider manual and the Ohio fee schedule. Telehealth and frequency are in separate plan policies RPC.0008.7700 and RPC.0025.7700. [1] |
Check an AmeriHealth Caritas claim against the row
Before an AmeriHealth Caritas Ohio claim goes out, compare it with the row above: the code is one the policy lists, the place of service and modifier match for a video visit, and the units fit the limit. Change the filters to compare AmeriHealth Caritas with another payer, then download the PDF of what you see.