BCBS of IL, TX, OK and NM (HCSC) MNT coverage: codes and telehealth
The short answerHCSC's public policy names 97802, 97803, 97804, G0270 and G0271 only inside its Preventive Services Policy (RP006), as services that can pay with no member cost share when the claim carries a preventive diagnosis and meets the grid. It publishes no visit limit, referral rule or dietitian billing rule in that policy.
By Javier Alvarez · Updated · 1 min read
1 row: HCSC. Public policy, not the member's benefits.
BCBS of IL, TX, OK and NM (HCSC)
HCSC Preventive Services Policy RP006 (commercial, effective April 1, 2026) · IL, TX, OK, NM
| 97802 | Limited (named in the preventive services grid (USPSTF and HRSA counseling rows). The policy does not describe diagnostic MNT billing.) [1] |
|---|---|
| 97803 | Limited (named in the preventive services grid (USPSTF and HRSA counseling rows). The policy does not describe diagnostic MNT billing.) [1] |
| G0270 | Limited (named in the preventive services grid (USPSTF and HRSA counseling rows). The policy does not describe diagnostic MNT billing.) [1] |
| G0271 | Limited (named in the preventive services grid (USPSTF and HRSA counseling rows). The policy does not describe diagnostic MNT billing.) [1] |
| Where it applies | Commercial plans of Blue Cross and Blue Shield of Illinois, Texas, Oklahoma and New Mexico, all divisions of HCSC. The Texas, Illinois, Oklahoma and New Mexico editions of RP006 (effective April 1, 2026) carry the same text. A Montana edition was not found. Plan documents and provider contracts override the policy. [1][2][3][4] |
| Diagnoses | Adults with a BMI of 30 or higher (weight loss row, 97802 to 97804). Adults with cardiovascular risk factors (diet counseling row, lists 97802, 97803, 97804, G0270, G0271, S9470). Prediabetes and midlife women aged 40 to 60 rows pay only with a code in "Diagnosis List 1". Diagnosis List 1 is printed at the end of the policy; it includes R73.03 and Z71.41 but not Z71.3, E66 or Z68 codes. [1] |
| Other codes | 97804 (group MNT) and S9470 appear in the same preventive rows. [1] |
| Telehealth POS | Illinois edition of the telemedicine policy (CPCP033, Sept. 26, 2025): telehealth professional claims on a CMS-1500 use POS 02 or 10. Not nutrition specific. Texas, Oklahoma and New Mexico editions were not checked. [5] |
| Telehealth modifier | Illinois edition of CPCP033: modifiers FQ, FR, G0, GT, 93 and 95 go on the code when the code is not a telemedicine specific code. Not nutrition specific. [5] |
| Telehealth rules | The Texas Telemedicine Code List (updated March 25, 2026) includes 97802, 97803, 97804, G0270, G0271 and S9470. A matching list for the other states was not found. [6] |
| Visit limits | Not published: call the payer. |
| Referral and prior auth | Not published: call the payer. |
| Payment | For preventive level payment with no member cost share, the claim must include a preventive diagnosis code and a preventive procedure code, meet medical policy review criteria and fall within USPSTF, ACIP, HRSA or Bright Futures guidelines. Out of network preventive care is not guaranteed at no cost share. [1] |
| Also | The policy separates preventive from diagnostic care. Its example of diagnostic care is a patient diagnosed with diabetes referred for nutritional counseling. Services not payable at the preventive level may be payable under another part of the medical plan. [1] |
- Blue Cross and Blue Shield of Texas (HCSC): RP006 Preventive Services Policy (effective April 1, 2026), checked October 30, 2026
- Blue Cross and Blue Shield of Illinois (HCSC): RP006 Preventive Services Policy (effective April 1, 2026), checked October 30, 2026
- Blue Cross and Blue Shield of Oklahoma (HCSC): RP006 Preventive Services Policy (effective April 1, 2026), checked October 30, 2026
- Blue Cross and Blue Shield of New Mexico (HCSC): RP006 Preventive Services Policy (effective April 1, 2026), checked October 30, 2026
- Blue Cross and Blue Shield of Illinois: CPCP033 Telemedicine and Telehealth/Virtual Health Care Services Policy (effective Sept. 26, 2025), checked October 30, 2026
- Blue Cross and Blue Shield of Texas: Telemedicine Code List (effective Jan. 1, 2022, updated March 25, 2026), checked October 30, 2026
Check a HCSC claim against the row
Before a BCBS of IL, TX, OK and NM (HCSC) 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 HCSC with another payer, then download the PDF of what you see.