Pennsylvania Medicaid MNT coverage: codes, telehealth and referrals
The short answerPennsylvania Medical Assistance enrolls licensed dietitian-nutritionists as Provider Type 23, but the fee-for-service code they bill is S9470 with modifiers U3 and TJ, for beneficiaries under 21 with weight management problems: one visit per day, no prior authorization, $26.46 a visit. 97802 is not on the outpatient fee schedule, and we found no adult dietitian benefit.
By Javier Alvarez · Updated · 1 min read
1 row: Medicaid (by state) · Pennsylvania. Public policy, not the member's benefits.
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
Check a Medicaid claim against the row
Before a Pennsylvania 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. More on the Pennsylvania Medicaid coverage guide.