Iowa Medicaid MNT coverage: codes and referrals
The short answerIowa Medicaid's rule pays for nutritional counseling by a licensed dietitian for members aged 20 and under, when the dietitian is employed by or under contract with a physician, hospital or screening center. The problem must be severe enough to need more than standard medical management. WIC-eligible members need a WIC referral. The HCBS health and disability waiver also lists nutritional counseling as a service. The rule names no CPT codes.
By Javier Alvarez · Updated · 1 min read
1 row: Medicaid (by state) · Iowa. Public policy, not the member's benefits.
Iowa Medicaid
Medicaid (Iowa Administrative Code 441-78) · Iowa
| 97802 | Not named (rule covers nutritional counseling without naming CPT codes.) [1] |
|---|---|
| 97803 | Not named (rule covers nutritional counseling without naming CPT codes.) [1] |
| G0270 | Not published |
| G0271 | Not published |
| Where it applies | Members aged 20 and under. The same wording appears for physician services (78.1(14)), screening centers (78.18(7)) and hospital outpatient services (78.31(4)"h"). [1] |
| Diagnoses | A nutritional problem or condition of a degree of severity that nutritional counseling beyond that normally expected as part of the standard medical management is warranted. [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 | For members eligible for WIC, a WIC referral is required, and medical necessity for counseling beyond what WIC offers must be documented. [1] |
| Who can bill | A licensed dietitian employed by or under contract with a physician, a screening center or a hospital. The rule does not provide for an independent dietitian billing on their own. [1] |
| Also | Under the HCBS health and disability waiver, nutritional counseling is a separate service billed in 15-minute units, with no age limit stated (78.34(12)). [1] |
Check a Medicaid claim against the row
Before an Iowa Medicaid 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 Medicaid with another payer, then download the PDF of what you see.