Oregon Medicaid MNT coverage: codes and referrals
The short answerOregon Health Authority guidance says 97802-04 can be billed to Medicaid for medical nutrition therapy when the member has a condition on its covered list (Appendix N, tied to the OHP Prioritized List). Children get all medically necessary nutrition services under EPSDT. Referrals follow each coordinated care organization's protocol.
By Javier Alvarez · Updated · 1 min read
1 row: Medicaid (by state) · Oregon. Public policy, not the member's benefits.
Oregon Medicaid
Medicaid (Oregon Health Plan, OHA guidance) · Oregon
| 97802 | Listed (named by OHA as billable to Medicaid for MNT for covered conditions) [1] |
|---|---|
| 97803 | Listed (named with 97802 and 97804 as the MNT codes; the HRSN FAQ also names it as the MTM reassessment code) [1][2] |
| G0270 | Not named [1] |
| G0271 | Not named [1] |
| Where it applies | MNT is billed to Medicaid (not to health-related social needs funds) when the member has a health condition on the OHP Prioritized List for which MNT is an indicated treatment. In the rare case the condition cannot be billed under the State Plan, the service can be billed under HRSN. [1] |
| Diagnoses | OHA lists the conditions billable to Medicaid for MNT and referral for RDN assessment. They include pregnancy, type 1 and type 2 diabetes, end stage renal disease and chronic kidney disease, heart failure, hypertension, dyslipidemias, nutritional deficiencies, intestinal malabsorption, obesity in adults and children, and eating disorders such as anorexia and bulimia. [3][1] |
| Other codes | 97804 (group) is named with 97802 and 97803 as MNT codes. 98961 is the HRSN nutrition education code. [1][2] |
| 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 the HRSN medically tailored meals assessment (97802), OHA says no prior authorization is needed, but a PCP referral to a dietitian may be needed depending on the CCO. OHA advises PCP or specialist involvement. [2] |
| Who can bill | OHA prefers a licensed registered dietitian nutritionist. When no RDN is available, an MD, DO, NP, PA or the member's primary specialist may do the MTM assessment, following the Nutrition Care Process. [2][1] |
| Managed care plans | Referrals follow each CCO's protocol, and OHA tells CCOs that nutrition assessments for covered conditions already covered by Medicaid should be billed through Medicaid, not HRSN. [1][2] |
| Also | Under EPSDT, children must receive all medically necessary and appropriate nutrition-related services regardless of their underlying health condition. An RDN assessment is covered under EPSDT, not HRSN, when the member meets the EPSDT definitions in OAR 410-151-0001. [3][1] |
- Oregon Health Authority: CCO HRSN Guidance Document (September 2026), checked October 30, 2026
- Oregon Health Authority: CCO Frequently Asked Questions (07/01/2026), checked October 30, 2026
- Oregon Health Authority: OHP HRSN medically tailored meals clinical eligibility guide (updated 01/02/2025), checked October 30, 2026
Check a Medicaid claim against the row
Before an Oregon 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.