97802 with Medicare: what the policy says
The short answerYes. Medicare pays 97802 to a registered dietitian, but only once, for the first visit of a new patient. Every later individual visit is 97803. The claim needs a diabetes or renal diagnosis and the referring physician's NPI.
By Javier Alvarez · Updated · 2 min read
1 row: Medicare. Public policy, not the member's benefits.
Medicare
Original Medicare (Part B) · All states
| 97802 | Listed (once, for the first visit) [1] |
|---|---|
| 97803 | Listed (every later individual visit) [1] |
| G0270 | Listed (hours beyond the base, after a second referral in the same year) [1] |
| G0271 | Listed (group, after a second referral in the same year) [1] |
| Diagnoses | Diabetes and kidney disease, or a kidney transplant in the last 36 months. [2] |
| Telehealth POS | POS 02 or 10. POS 10 pays the non-facility rate. Patients can be at home through December 31, 2027. [3][4][5] |
| Telehealth modifier | 95 for audio and video, 93 for audio only. [3] |
| Visit limits | 3 hours the first calendar year, 2 hours each year after. Unused hours don't carry over. More hours need a second referral (G0270, G0271). [2][1] |
| Referral and prior auth | A referral from the treating doctor is required. [2] |
| Who can bill | Registered dietitians and nutrition professionals. Dietitians are eligible telehealth practitioners. [4] |
| Payment | 2026 national rate paid to a dietitian: $31.23 per unit of 97802, $26.97 per unit of 97803 or G0270. The patient pays nothing. [6][2] |
- CMS: Medicare Claims Processing Manual ch. 4, section 300 Medical Nutrition Therapy (Rev. 12694, 06-21-24), checked October 30, 2026
- Medicare.gov: Medical nutrition therapy services, checked October 22, 2026
- CMS: Change Request 13582 (POS 02 or 10 paired with modifier 95 or 93, PDF), checked October 22, 2026
- CMS MLN901705: Telehealth and Remote Patient Monitoring, December 2025 (PDF), checked October 22, 2026
- CMS: Telehealth FAQ, updated 10/8/2026 (home telehealth through Dec 31, 2027, PDF), checked October 22, 2026
- CMS: PFS Relative Value Files, RVU26D, checked October 22, 2026
What Medicare's policy says about 97802
97802 is the CPT code for medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes. At Medicare it is listed: named in the payer's public policy. Each line below is from Medicare's own text:
- Where it is listed. Named as a payable MNT code in Claims Processing Manual ch. 4, section 300.4, with the note that it must only be used for the initial visit. (CMS, checked October 30, 2026)
- Billed with. Claim must carry diabetes or renal disease. No diagnosis: unprocessable. Other diagnosis: denied as not reasonable and necessary. The referring physician's NPI must be on the CMS-1500. (CMS, checked October 30, 2026)
- When it pays. Used only once, for the initial assessment of a new patient. All later individual visits, including reassessments, go to 97803 and later group visits to 97804. (CMS, checked October 30, 2026)
- Units. Each 15 minutes. The dietitian may choose how many units are given per day if the NCD and 42 CFR 410.130-410.134 are met. (CMS, checked October 30, 2026; CMS, checked October 30, 2026)
- What the member pays. Medicare Part B pays 100% of the fee schedule amount for MNT and the Part B deductible does not apply (42 CFR 410.152(l)(7) and 410.160(b)(11)). Dietitians must accept assignment, so the patient pays nothing. Noridian's MNT page also says copayment, coinsurance and deductible are waived. (Noridian Medicare (JF Part A), checked October 30, 2026)
- Who can bill it. Registered dietitian or nutrition professional, or a hospital that has their reassigned benefits. Not payable incident to physician services. Dietitian/nutritionist specialty code is 71. (CMS, checked October 30, 2026)
- Telehealth. On the CMS CY 2026 list of Medicare telehealth services (action: Maintain). (CMS, checked October 30, 2026)
97802 at other payers
- 97802 with BCBS of IL, TX, OK and NM (HCSC): limited.
- 97802 with Blue Cross NC: listed.
The rest of Medicare's MNT rules
The Medicare row has its codes, telehealth rule, limits and referrals, each with its source. Other codes we checked at Medicare: 97803, 97804, G0270, G0271, G0447, G0473, Z68 and G0108. What 97802 means at any payer is on the 97802 code page. Before the claim goes out, compare it with the row in the table above, then download the PDF of what you see.