Capital Blue Cross MNT coverage: limits and referrals
The short answerCapital Blue Cross covers nutritional therapy (counseling and education) for medically necessary diagnoses on commercial plans, with a 20-visit limit per benefit period for the chronic conditions benefit and for non-preventive obesity counseling. It needs a physician prescription, no preauthorization, and the limit applies to telehealth visits too.
By Javier Alvarez · Updated · 1 min read
1 row: Capital Blue Cross. Public policy, not the member's benefits.
Capital Blue Cross
Commercial lines (Provider Manual 2026) · Pennsylvania
| 97802 | Not published |
|---|---|
| 97803 | Not published |
| G0270 | Not published |
| G0271 | Not published |
| Where it applies | Commercial lines of business only. Does not apply to Medicare or FEP members. [1] |
| Diagnoses | Counseling and education where dietary modification is medically necessary, including heart disease, diabetes, obesity, morbid obesity and other chronic conditions. Billed with eligible chronic condition, obesity or diabetes coding. [1] |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | Not published: call the payer. |
| Telehealth rules | Visit limits for nutritional therapy also apply to telehealth and virtual care visits. [1] |
| Visit limits | 20 visits per benefit period for the chronic conditions benefit and 20 visits per benefit period for non-preventive obesity counseling only. The limit does not apply to the diabetes nutritional therapy benefits. It also applies to telehealth and virtual care visits. [1] |
| Referral and prior auth | The benefit is available when prescribed by a physician as medically necessary. Nutritional therapy does not require preauthorization. [1] |
| Payment | Licensed dietician-nutritionists are paid at 85 percent of the Physician Provider Program Fee Schedule. [1] |
Check a Capital Blue Cross claim against the row
Before a Capital Blue Cross 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 Capital Blue Cross with another payer, then download the PDF of what you see.