Blue Cross Blue Shield of Michigan MNT coverage: codes, limits and referrals
The short answerBCBSM's public nutrition documents are plan specific. Blue Care Network's commercial HMO policy named 97802, 97803, 97804, G0270, G0271 and S9470 but was retired on 8/15/23. Medicare Plus Blue PPO pays the same six codes for eating disorder and Z71.3 diagnoses. No general BCBSM commercial PPO MNT policy was found.
By Javier Alvarez · Updated · 1 min read
1 row: Blue Cross Blue Shield of Michigan. Public policy, not the member's benefits.
Blue Cross Blue Shield of Michigan
Blue Care Network commercial HMO policy; Medicare Plus Blue enhanced benefit; State Health Plan PPO · Michigan
| 97802 | Listed (listed as established codes in the Blue Care Network policy (retired 8/15/23) and in the Medicare Plus Blue PPO enhanced benefit policy.) [1][2] |
|---|---|
| 97803 | Listed (listed as established codes in the Blue Care Network policy (retired 8/15/23) and in the Medicare Plus Blue PPO enhanced benefit policy.) [1][2] |
| G0270 | Listed (listed as established codes in the Blue Care Network policy (retired 8/15/23) and in the Medicare Plus Blue PPO enhanced benefit policy.) [1][2] |
| G0271 | Listed (listed as established codes in the Blue Care Network policy (retired 8/15/23) and in the Medicare Plus Blue PPO enhanced benefit policy.) [1][2] |
| Where it applies | Blue Care Network policy: commercial HMO, including self-funded groups unless otherwise specified; effective 8/15/23 and marked retired. Medicare Plus Blue PPO enhanced benefit: Medicare Advantage group plans, effective 01/01/2026. State Health Plan PPO: State of Michigan employee plan. Coverage is set by each member certificate or group. [1][2][3] |
| Diagnoses | Blue Care Network: limited to conditions where diet therapy is part of an active treatment program of a chronic disease. Examples listed include PKU, obesity, diabetes, eating disorders, chronic renal disease, hypertension and celiac disease. Medicare Plus Blue PPO: eating disorder codes F50.x and Z71.3. [1][2] |
| Other codes | 97804 and S9470 are listed with the other codes in both documents. [1][2] |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | Not published: call the payer. |
| Visit limits | State Health Plan PPO: up to six visits per calendar year, in network. The Blue Care Network policy removed its limit of 6 visits per calendar year when it was retired. Medicare Plus Blue PPO: no frequency limits. [3][1][2] |
| Referral and prior auth | Blue Care Network: the service must be authorized by the member's PCP, except for Self-Referral Option members seeking Tier 2 coverage. [1] |
| Who can bill | Blue Care Network policy: useful when ordered by a physician and furnished by a registered dietitian, licensed nutritionist or other qualified licensed health professional. Medicare Plus Blue PPO: no provider limitations. [1][2] |
| Medicare rules | Medicare Plus Blue PPO enhanced benefit pays 97802, 97803, 97804, G0270, G0271 and S9470 only with eating disorder codes or Z71.3. Payment is the lesser of the Medicare allowed amount or the charge, minus member cost share. [2] |
- Blue Care Network (BCBSM): Medical Policy, Nutritional Counseling (effective 8/15/23, policy retired), checked October 30, 2026
- Blue Cross Blue Shield of Michigan: Medicare Plus Blue PPO Enhanced Benefit Policy, Nutritional Counseling Related to Approved Medical Conditions (approved 02/10/2026), checked October 30, 2026
- Blue Cross Blue Shield of Michigan: State Health Plan PPO Your Benefit Guide (January 1, 2025), checked October 30, 2026
Check a Blue Cross Blue Shield of Michigan claim against the row
Before a Blue Cross Blue Shield of Michigan 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 Blue Cross Blue Shield of Michigan with another payer, then download the PDF of what you see.