Medicaid MNT coverage by state: codes, telehealth and limits
The short answerIt depends on the state. Of the 10 Medicaid programs with a public policy here, California, Georgia, Massachusetts, New York, North Carolina, Ohio, Texas and Washington list both 97802 and 97803, though Georgia limits them to children and North Carolina to children and pregnant or postpartum members. Pennsylvania pays S9470 instead, and Illinois pays the codes only for Qualified Medicare Beneficiaries.
By Javier Alvarez · Updated · 2 min read
10 rows: Medicaid (by state). Public policy, not the member's benefits.
Medi-Cal (California Medicaid)
Medicaid fee-for-service and managed care · California
| 97802 | Listed [1] |
|---|---|
| 97803 | Listed [1] |
| G0270 | Not published |
| G0271 | Not published |
| Diagnoses | Not published: call the payer. |
| Other codes | 97804, in 30-minute units. [1] |
| Telehealth POS | POS 02 or 10. [2] |
| Telehealth modifier | 95 for video, 93 for audio only. [2] |
| Visit limits | Fee-for-service: 3 hours the first calendar year, 2 hours each later calendar year; more with a Treatment Authorization Request (TAR). 97802 to 97804 can't be billed on the same date as DSMT (G0108, G0109). [1] |
| Referral and prior auth | Not published: call the payer. |
| Managed care plans | Plan-specific. For example, Partnership HealthPlan pays up to 12 hours of 97803 per rolling 12 months without a TAR. [3] |
- DHCS: Medi-Cal Provider Manual, Medicine: Nutrition Counseling, updated Oct 2025 (PDF), checked September 28, 2026
- DHCS: Medi-Cal Provider Manual, Telehealth Modalities, updated Nov 2025 (PDF), checked September 28, 2026
- Partnership HealthPlan of California: MCUP3052 Medical Nutrition Therapy Services (PDF), checked September 28, 2026
Georgia Medicaid
Children's Intervention Services · Georgia
| 97802 | Listed (with modifier HA) [1] |
|---|---|
| 97803 | Listed (with modifiers HA and TS) [1] |
| G0270 | Not published |
| G0271 | Not published |
| Where it applies | Children's Intervention Services: members from birth to 21 with a physical disability or developmental delay. No dietitian MNT benefit for adults was found in the current manuals. [1] |
| Diagnoses | Not published: call the payer. |
| Other codes | 97804 with modifier HA. [1] |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | Not published: call the payer. |
| Visit limits | 97802-HA: 1 visit a year; 97803-HA-TS: 12 visits a year; 97804-HA: 12 visits a year. [1] |
| Referral and prior auth | A PCP letter of medical necessity or a PCP-approved plan of care, and the PCP's NPI on every claim. Prior authorization past 8 units per month per specialty; not needed for evaluations. [1] |
| Who can bill | A Georgia-licensed dietitian enrolled as an individual provider. [1] |
| Payment | Maximum allowable: 97802 $28.09; 97803 $23.94; 97804 $13.00. [1] |
- Georgia DCH: Part II Policies and Procedures for Children's Intervention Services (CIS), July 1, 2026 (PDF), checked September 28, 2026
Illinois Medicaid
Medicaid (HFS) · Illinois
| 97802 | Limited (indicator 09: QMB coverage only) [1][2] |
|---|---|
| 97803 | Limited (indicator 09: QMB coverage only) [1][2] |
| G0270 | Limited (indicator 09: QMB coverage only) [1][2] |
| G0271 | Limited (indicator 09: QMB coverage only) [1][2] |
| Diagnoses | Not published: call the payer. |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | Not published: call the payer. |
| Visit limits | Not published: call the payer. |
| Referral and prior auth | Not published: call the payer. |
| Who can bill | No dietitian provider type found. [1] |
| Also | Covered alternative: DSMES (G0108, G0109) by ADCES-accredited or ADA-recognized organizations, up to 18 hours per 12 months (3 individual, 15 group). [3] |
- Illinois HFS: Practitioner Fee Schedule, eff. 07/01/2026, updated 09/15/2026 (PDF), checked September 28, 2026
- Illinois HFS: Practitioner Fee Schedule key, eff. 07/01/2026 (PDF), checked September 28, 2026
- Illinois HFS: Provider notice, updates to diabetes management programs (Jul 29, 2022), checked September 28, 2026
MassHealth (Massachusetts Medicaid)
MassHealth · Massachusetts
| 97802 | Listed [1][2] |
|---|---|
| 97803 | Listed [1][2] |
| G0270 | Listed [1][2] |
| G0271 | Listed [1][2] |
| Diagnoses | Nutritional diagnostic therapy and counseling to manage a medical condition; no diagnosis list in the regulation. [1] |
| Other codes | 97804; DSMT G0108 and G0109 for prediabetes or diabetes. [1][2] |
| Telehealth POS | POS 02 or 10. [3] |
| Telehealth modifier | 95, 93 or GQ. [3] |
| Visit limits | Not published: call the payer. |
| Referral and prior auth | Not published: call the payer. |
| Who can bill | Community health centers, physicians, hospital outpatient departments, and independently enrolled nurse practitioners and nurse-midwives. No MassHealth provider type for independent dietitian billing was found. [1][2] |
- Massachusetts: 130 CMR 405.000 Community Health Center Services, incl. 405.475 Medical Nutrition Therapy (PDF), checked September 28, 2026
- MassHealth: Physician Bulletin 86, Medical Nutrition Therapy and Diabetes Self-Management Training (July 2007), checked September 28, 2026
- MassHealth: All Provider Bulletin 379, telehealth (Oct 2023), checked September 28, 2026
New York Medicaid
Fee-for-service and Medicaid Managed Care · New York
| 97802 | Listed (15-minute units) [1] |
|---|---|
| 97803 | Listed (15-minute units) [1] |
| G0270 | Not published |
| G0271 | Not published |
| Diagnoses | Not published: call the payer. |
| Other codes | 97804, in 30-minute units. [1] |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | Not published: call the payer. |
| Visit limits | Not published: call the payer. |
| Referral and prior auth | Recommended by a licensed practitioner acting within their scope (physicians, PAs, NPs, certified dietitians/nutritionists and others). [1] |
| Who can bill | Dietitians/nutritionists certified under NYS Education Law Article 157 and enrolled in NYS Medicaid, since January 1, 2024. [1][2] |
| Managed care plans | Medicaid Managed Care enrollees are covered too; contract with the plan, whose billing rules and fees apply. [2] |
- eMedNY: Dietitian/Nutritionist Policy Manual (effective Jan 1, 2024, PDF), checked September 28, 2026
- NYS DOH: Medicaid Update, December 2023: MNT services provided by qualified dietitians/nutritionists, checked September 28, 2026
NC Medicaid
Medicaid (Clinical Coverage Policy 1-I) · North Carolina
| 97802 | Listed [1] |
|---|---|
| 97803 | Listed [1] |
| G0270 | Not published |
| G0271 | Not published |
| Where it applies | Members under 21 with a qualifying condition; pregnant and postpartum women who meet the criteria. [1] |
| Diagnoses | Not published: call the payer. |
| Telehealth POS | The usual place of service. [1] |
| Telehealth modifier | GT for audio and video. Both codes are telehealth-eligible. [1] |
| Visit limits | 97802: 4 units per date of service and 4 units per 270 days. 97803: 4 units per date of service and 20 units per 365 days. Both across all providers. [1] |
| Referral and prior auth | No prior approval. An order or referral from the primary or specialty care provider is required. [1] |
| Who can bill | An NC-licensed dietitian/nutritionist or a CDR-registered dietitian, with their own NPI or their employer's. [1][2] |
- NC Medicaid: Clinical Coverage Policy 1-I, Dietary Evaluation and Counseling and Medical Lactation Services (PDF), checked September 28, 2026
- NC Medicaid: Registered Dieticians and Nutritionists Added to the List of Eligible Providers (Dec 2020), checked September 28, 2026
Ohio Medicaid
Medicaid (OAC 5160-8-41) · Ohio
| 97802 | Listed [1][2] |
|---|---|
| 97803 | Listed [1][2] |
| G0270 | Not published |
| G0271 | Not published |
| Diagnoses | The rule states no age limit and no diagnosis list. [1] |
| Other codes | 97804. Lactation consultation and DSMT are also covered services. [1] |
| Telehealth POS | The practitioner site's place of service. [3] |
| Telehealth modifier | GT, plus Ohio's patient-location modifier and the rendering NPI. [3] |
| Visit limits | Not published: call the payer. |
| Referral and prior auth | Not published: call the payer. |
| Who can bill | Licensed and registered dietitians, independently or through a professional medical group, ambulatory health care clinic or FQHC/RHC. [1] |
| Payment | The lesser of your charge or the fee schedule: 97802 $22.84; 97803 $19.95; 97804 $9.97 (non-facility maximum, Appendix DD revised 07/01/2025). [1][2] |
- Ohio Administrative Code: Rule 5160-8-41, Services provided by a dietitian (eff. Oct 1, 2024), checked September 28, 2026
- Ohio Department of Medicaid: Appendix DD to rule 5160-1-60, Non-Institutional Fee Schedule, revised 07/01/2025 (PDF), checked September 28, 2026
- Ohio Administrative Code: Rule 5160-1-18, Telehealth, checked September 28, 2026
Pennsylvania Medicaid
Medical Assistance (fee-for-service) · Pennsylvania
| 97802 | Not listed (not on the MA outpatient fee schedule) [1] |
|---|---|
| 97803 | Not listed (not on the MA outpatient fee schedule) [1] |
| G0270 | Not published |
| G0271 | Not published |
| Where it applies | Beneficiaries under 21 with weight management problems. No adult dietitian benefit was found. [2] |
| Diagnoses | Not published: call the payer. |
| Other codes | S9470 with modifiers U3 and TJ, one visit per day. [2] |
| Telehealth POS | The bulletin lists POS 11, 12 and 99; the online fee schedule also lists 02 and 10. [2][1] |
| Telehealth modifier | Not published: call the payer. |
| Visit limits | Not published: call the payer. |
| Referral and prior auth | No prior authorization. [2] |
| Who can bill | Provider Type 23 Nutritionist, specialty 230 (a Pennsylvania license and a dietetic registration card). [3] |
| Payment | $26.46 per visit for Provider Type 23. [1] |
- PA DHS: Medical Assistance Outpatient Fee Schedule search, checked September 28, 2026
- PA DHS: MA Bulletin 01-20-06/23-20-01 et al., Updates to Childhood Nutrition and Weight Management Services, May 26, 2020 (PDF), checked September 28, 2026
- PA DHS: Requirements for Provider Type 23, Nutritionist (PDF), checked September 28, 2026
Texas Medicaid
CCP and Healthy Texas Women · Texas
| 97802 | Listed (4 units per rolling year) [1][2] |
|---|---|
| 97803 | Listed (12 units per rolling year) [1][2] |
| G0270 | Not published |
| G0271 | Not published |
| Where it applies | Comprehensive Care Program (CCP) clients 20 and under, and the Healthy Texas Women program. [1][2] |
| Diagnoses | In CCP, obesity alone is not a benefit without a comorbid condition. [1] |
| Other codes | 97804 (8 units per rolling year) and S9470 (4 visits per rolling year; in Healthy Texas Women, 1 visit a year without prior authorization). [1][2] |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | 95 for synchronous audio and video; 93 for audio only where allowed. [1] |
| Visit limits | Per rolling year: 97802 4 units; 97803 12 units; 97804 8 units; S9470 4 visits. Healthy Texas Women uses the same unit limits. [1][2] |
| Referral and prior auth | CCP: prescribed by a physician. [1] |
| Managed care plans | Plans can add stricter rules. Community First Health Plans limits MNT to diabetes, renal disease and kidney transplant from August 3, 2026; that is its rule, not a statewide one. [3] |
- TMHP: TMPPM Children's Services Handbook, Medical Nutrition Counseling Services (CCP), Sept 2026 (PDF), checked September 28, 2026
- TMHP: TMPPM Healthy Texas Women Program Handbook, Sept 2026 (PDF), checked September 28, 2026
- Community First Health Plans: MNT coding and billing guidance (one Texas Medicaid plan, eff. Aug 3, 2026), checked September 28, 2026
Washington Apple Health (Medicaid)
Apple Health · Washington
| 97802 | Listed (8 units a year) [1] |
|---|---|
| 97803 | Listed (4 units a day) [1] |
| G0270 | Not published |
| G0271 | Not published |
| Diagnoses | 21 and older: BMI 30 or more, cardiovascular risk factors, diabetes or chronic kidney disease, billed with EPA #870001644; other adults need prior authorization. 20 and under: no EPA or PA, EPSDT rules apply. [1][2] |
| Other codes | 97804, 2 units a day. [1] |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | Not published: call the payer. |
| Visit limits | 97802: 8 units a year. 97803: 4 units a day. 97804: 2 units a day. 97803 and 97804 together: 96 units per calendar year. [1] |
| Referral and prior auth | Required, from a physician, PA or ARNP. [1][2] |
| Who can bill | A registered dietitian with an HCA core provider agreement and an NPI. [1] |
| Payment | Non-facility maximum allowable from July 1, 2026: 97802 $22.36, 97803 $19.30, 97804 $10.32. [3] |
- Washington HCA: Medical Nutrition Therapy Billing Guide, effective Oct 1, 2025 (PDF), checked September 28, 2026
- Washington State Legislature: Chapter 182-555 WAC, Medical nutrition therapy, checked September 28, 2026
- Washington HCA: Medical Nutrition Therapy fee schedule, effective July 1, 2026 (XLSX), checked September 28, 2026
10 state Medicaid programs side by side
Each state runs Medicaid under its own manual, so the same two codes mean different things across the border. Of the 10 programs here, 8 list both 97802 and 97803 in a public policy; the rest pay through a narrower program, a different code or not at all. Each state's row, with its sources, is on its own page.
| State | 97802 | 97803 | Who can bill | Visit limits |
|---|---|---|---|---|
| Medi-Cal (California Medicaid) | Listed | Listed | Not published: call the payer. | Fee-for-service: 3 hours the first calendar year, 2 hours each later calendar year; more with a Treatment Authorization Request (TAR). 97802 to 97804 can't be billed on the same date as DSMT (G0108, G0109). |
| Georgia Medicaid | Listed | Listed | A Georgia-licensed dietitian enrolled as an individual provider. | 97802-HA: 1 visit a year; 97803-HA-TS: 12 visits a year; 97804-HA: 12 visits a year. |
| Illinois Medicaid | Limited | Limited | No dietitian provider type found. | Not published: call the payer. |
| MassHealth (Massachusetts Medicaid) | Listed | Listed | Community health centers, physicians, hospital outpatient departments, and independently enrolled nurse practitioners and nurse-midwives. No MassHealth provider type for independent dietitian billing was found. | Not published: call the payer. |
| New York Medicaid | Listed | Listed | Dietitians/nutritionists certified under NYS Education Law Article 157 and enrolled in NYS Medicaid, since January 1, 2024. | Not published: call the payer. |
| NC Medicaid | Listed | Listed | An NC-licensed dietitian/nutritionist or a CDR-registered dietitian, with their own NPI or their employer's. | 97802: 4 units per date of service and 4 units per 270 days. 97803: 4 units per date of service and 20 units per 365 days. Both across all providers. |
| Ohio Medicaid | Listed | Listed | Licensed and registered dietitians, independently or through a professional medical group, ambulatory health care clinic or FQHC/RHC. | Not published: call the payer. |
| Pennsylvania Medicaid | Not listed | Not listed | Provider Type 23 Nutritionist, specialty 230 (a Pennsylvania license and a dietetic registration card). | Not published: call the payer. |
| Texas Medicaid | Listed | Listed | Not published: call the payer. | Per rolling year: 97802 4 units; 97803 12 units; 97804 8 units; S9470 4 visits. Healthy Texas Women uses the same unit limits. |
| Washington Apple Health (Medicaid) | Listed | Listed | A registered dietitian with an HCA core provider agreement and an NPI. | 97802: 8 units a year. 97803: 4 units a day. 97804: 2 units a day. 97803 and 97804 together: 96 units per calendar year. |
Children under 21 have the broadest protection everywhere: under EPSDT, a state must cover medically necessary services for them (Medicaid.gov). Managed care plans then add their own rules on top of the state's.
Your state isn't here?
We only add a state when its Medicaid agency publishes the rule. Call the state's provider line or your managed care plan, and ask which codes a dietitian can bill, whether a referral is needed and how many units a year.