Maryland Medicaid MNT coverage: codes, limits and referrals
The short answerMaryland Medicaid covers nutrition services for participants age 20 and younger when medically necessary and provided by a licensed dietitian nutritionist. It lists 97802 ($31.13 per unit, up to 12 units per day), 97803 ($27.41, up to 11 per day) and 97804, with telehealth allowed. Most members go through HealthChoice MCOs.
By Javier Alvarez · Updated · 1 min read
1 row: Medicaid (by state) · Maryland. Public policy, not the member's benefits.
Maryland Medicaid
Medicaid (EPSDT Nutrition Services, HealthChoice) · Maryland
| 97802 | Listed (max 12 units per date of service, $31.13 per unit, no pre-auth, telehealth allowed) [1] |
|---|---|
| 97803 | Listed (max 11 units per date of service, $27.41 per unit, no pre-auth, telehealth allowed) [1] |
| G0270 | Not named [1] |
| G0271 | Not named [1] |
| Where it applies | Nutrition services are covered for participants 20 years of age and younger when medically necessary and provided by a licensed dietitian nutritionist. For ages 21 and over, the manual says fee-for-service community-based therapy coverage is limited to physical therapy and that MCOs usually handle referrals. [1] |
| Diagnoses | Not published: call the payer. |
| Other codes | 97804 group nutrition service: max 6 units per date of service, $14.71 per unit, no pre-auth, telehealth allowed. [1] |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | Not published: call the payer. |
| Telehealth rules | The schedule's Telehealth Allowance column shows Y for 97802, 97803 and 97804. The manual does not state a POS or modifier for these codes. [1] |
| Visit limits | Maximum units per date of service: 97802 12 units, 97803 11 units, 97804 6 units. The manual says the maximum units are the total that can be billed on the same day, and claims over the maximum are rejected. [1] |
| Referral and prior auth | Preauthorization is not required under fee-for-service Medicaid, but a quarterly care plan is expected to be shared with the participant's primary care provider. For MCO enrollees, contact the MCO for preauthorization. [1] |
| Who can bill | A licensed dietitian nutritionist enrolled as provider type 85 (Nutritionist) with an individual Maryland Medicaid number through ePREP. Nutritionists and dietitians must be licensed where they practice, and claims must carry the rendering provider's MA number and NPI. [1] |
| Payment | Maximum payment: 97802 $31.13; 97803 $27.41; 97804 $14.71. The fee schedule section is headed 'Effective January 1, 2025' inside a manual dated January 2026. [1] |
| Managed care plans | Nutrition services are covered through the HealthChoice Program and must be billed to the MCO for MCO enrollees. [1] |
Check a Medicaid claim against the row
Before a Maryland 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.