Florida Blue MNT coverage: codes, limits and referrals
The short answerFlorida Blue's guideline 01-99000-05 calls MNT medically necessary for any appropriate diagnosis when a registered dietitian or nutrition professional provides it on a treating physician's referral. It lists 97802, 97803, G0270 and G0271 and covers 3 hours the first calendar year and 2 hours each year after, more when medically necessary. It applies only under contracts with MNT and preventive benefits.
By Javier Alvarez · Updated · 1 min read
1 row: Florida Blue. Public policy, not the member's benefits.
Florida Blue
All lines of business, with exceptions · Florida
| 97802 | Listed [1] |
|---|---|
| 97803 | Listed [1] |
| G0270 | Listed [1] |
| G0271 | Listed [1] |
| Where it applies | All Florida Blue lines of business, under contracts that include MNT and preventive benefits. The Federal Employee Program and State Account Organization follow their own guidelines; Medicare Advantage follows NCD 180.1. [1] |
| Diagnoses | Medically necessary "for any appropriate diagnosis", for example diabetes, cardiovascular disease, renal disease, HIV, obesity and eating disorders. [1] |
| Other codes | 97804 and S9470. [1] |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | Not published: call the payer. |
| Visit limits | 3 hours in the first calendar year, 2 hours in later years, with a physician referral. More hours may be covered when medically necessary, such as a change in diagnosis or condition. [1] |
| Referral and prior auth | Referred by the treating physician. [1] |
| Who can bill | Payable when billed by a registered dietitian or nutrition professional. Not paid "incident to" physician services. [1] |
| Also | MNT and diabetes self-management training can be received in the same period but not billed on the same date of service. [1] |
Check a Florida Blue claim against the row
Before a Florida Blue 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 Florida Blue with another payer, then download the PDF of what you see. More on the Florida Blue coverage guide.