Z68 with Medicare: what the policy says
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 Z68
Z68 is the ICD-10-CM code for body mass index [BMI] (Z68.30 to Z68.39 and Z68.41 to Z68.45 are the adult BMI 30 or more codes Medicare lists). At Medicare it is limited: paid only in a narrow case, see the note. Each line below is from Medicare's own text:
- Where it is listed. Claims Processing Manual ch. 18 s.200.1 lists ICD-10 Z68.30 to Z68.39 and Z68.41 to Z68.45 as the BMI codes to report with G0447 and G0473. The list starts at BMI 30.0 and ends at BMI 70 or greater. (CMS, checked October 30, 2026)
- Billed with. Required with G0447 or G0473. Claims for more than 22 sessions in 12 months with these codes are denied. (CMS, checked October 30, 2026)
- When it pays. BMI of 30 kg/m2 or more defines obesity for the benefit. Claims with specialties or places of service outside the manual's lists are denied even with a valid Z68 code. (CMS, checked October 30, 2026; CMS, checked October 30, 2026)
- Also. For MNT the diagnosis that qualifies is diabetes or renal disease. A claim without one is denied, so Z68 alone does not support 97802 or 97803. (CMS, checked October 30, 2026)
Z68 at other payers
- Z68 with Blue Cross NC: limited.
- Z68 with Blue Cross and Blue Shield of Alabama: listed.
- Z68 with Aetna: listed.
- Z68 with UnitedHealthcare: listed.
- Z68 with Anthem Blue Cross and Blue Shield: 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: 97802, 97803, 97804, G0270, G0271, G0447, G0473 and G0108. What Z68 means at any payer is on the Z68 code page. Before the claim goes out, compare it with the row in the table above, then download the PDF of what you see.