New Mexico Medicaid MNT coverage: codes and who can bill
The short answerNew Mexico Medicaid pays nutritional assessment and counseling as a separate charge only for members under 21, by licensed dietitians or nutritionists employed by an eligible provider. Payment goes to the provider, not to the dietitian. When physicians or clinics provide nutrition counseling, it is included in the office visit code.
By Javier Alvarez · Updated · 1 min read
1 row: Medicaid (by state) · New Mexico. Public policy, not the member's benefits.
New Mexico Medicaid
Medicaid (8.310.3 NMAC, professional services) · New Mexico
| 97802 | Not named (the rule names no CPT codes.) [1] |
|---|---|
| 97803 | Not named (the rule names no CPT codes.) [1] |
| G0270 | Not published |
| G0271 | Not published |
| Where it applies | Rule effective January 1, 2023 (New Mexico Register Vol. XXXIII, Issue 24). Turquoise Care managed care plans were not reviewed. [1] |
| Diagnoses | Separate billing is limited to members under age 21. Counseling in prenatal or postpartum care is included in those global fees and not paid separately. [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 | Not published: call the payer. |
| Who can bill | A licensed dietician or licensed nutritionist under the direction of a licensed physician is an eligible provider type. Reimbursement is made to the eligible provider the dietitian works for, not directly to the dietitian. [1] |
| Also | Physicians, physician extenders and clinics must include nutritional services in the office visit code when they furnish them. [1] |
Check a Medicaid claim against the row
Before a New Mexico 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.