Washington Apple Health (Medicaid) MNT coverage: codes, limits and referrals
The short answerWashington Apple Health covers MNT by a registered dietitian with an HCA core provider agreement and a referral from a physician, PA or ARNP. Clients 20 and under need no authorization. Adults qualify with a BMI of 30 or more, cardiovascular risk factors, diabetes or chronic kidney disease using the expedited prior authorization number; other adults need prior authorization.
By Javier Alvarez · Updated · 1 min read
1 row: Medicaid (by state) · Washington. Public policy, not the member's benefits.
Washington Apple Health (Medicaid)
Apple Health · Washington
| 97802 | Listed (8 units a year) [1] |
|---|---|
| 97803 | Listed (4 units a day) [1] |
| G0270 | Not published |
| G0271 | Not published |
| Diagnoses | 21 and older: BMI 30 or more, cardiovascular risk factors, diabetes or chronic kidney disease, billed with EPA #870001644; other adults need prior authorization. 20 and under: no EPA or PA, EPSDT rules apply. [1][2] |
| Other codes | 97804, 2 units a day. [1] |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | Not published: call the payer. |
| Visit limits | 97802: 8 units a year. 97803: 4 units a day. 97804: 2 units a day. 97803 and 97804 together: 96 units per calendar year. [1] |
| Referral and prior auth | Required, from a physician, PA or ARNP. [1][2] |
| Who can bill | A registered dietitian with an HCA core provider agreement and an NPI. [1] |
| Payment | Non-facility maximum allowable from July 1, 2026: 97802 $22.36, 97803 $19.30, 97804 $10.32. [3] |
- Washington HCA: Medical Nutrition Therapy Billing Guide, effective Oct 1, 2025 (PDF), checked September 28, 2026
- Washington State Legislature: Chapter 182-555 WAC, Medical nutrition therapy, checked September 28, 2026
- Washington HCA: Medical Nutrition Therapy fee schedule, effective July 1, 2026 (XLSX), checked September 28, 2026
Check a Medicaid claim against the row
Before a Washington Apple Health (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 Washington Apple Health (Medicaid) coverage guide.