Priority Health MNT coverage: codes, limits and referrals
The short answerPriority Health accepts 97802, 97803, G0270 and G0271 for commercial members. The MNT benefit is for diabetes or kidney disease with a physician referral: 3 hours the first year, 2 hours after. For fully funded and self-funded groups, preventive dietitian visits have no six-visit cap and skip the deductible. Registered dietitians billing under a supervising physician in an office use the AE modifier.
By Javier Alvarez · Updated · 1 min read
1 row: Priority Health. Public policy, not the member's benefits.
Priority Health
Commercial, Medicare, Medicaid (Provider Manual: Nutrition counseling, education and therapy) · Michigan
| 97802 | Listed (initial one-on-one visit, 15 minutes) [1] |
|---|---|
| 97803 | Listed (follow-up one-on-one visit, 15 minutes) [1] |
| G0270 | Listed (accepted for MNT after a second referral in the same year) [1] |
| G0271 | Listed (accepted for MNT (group) after a second referral in the same year) [1] |
| Where it applies | The page applies to all plans. Medicaid follows Medicaid rules and guidelines for coverage and frequency. Page last updated 7/17/26. [1] |
| Diagnoses | The MNT benefit is limited to people with diabetes, kidney disease (not on dialysis), or after a kidney transplant, when ordered by the physician. The nutrition education and counseling benefit is available to members with a diabetes or kidney disease diagnosis. [1] |
| Other codes | 97804 (group, 30 minutes or more) is accepted. For Medicare, S9452 and S9470 are accepted for nutrition education and counseling, one unit per date of service. [1] |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | Not published: call the payer. |
| Visit limits | 3 hours in the first year, 2 hours in later years. More hours are covered if the physician finds a change in condition, diagnosis or treatment and orders them. Units billed should total the time spent, so a 30-minute visit is 2 units. [1] |
| Referral and prior auth | Members across all lines of business must be referred by the physician overseeing their diabetes care. [1] |
| Who can bill | Hospitals and facilities report revenue code 0942 on the UB04, and home care agencies use 0589. Registered dietitians in a provider office bill under the supervising physician with the AE modifier. MNT must be provided by a registered or licensed dietitian. [1] |
| Payment | There is no longer a six-visit limit for preventive dietitian visits. More than six visits are covered in full as a preventive guideline and the deductible does not apply. This applies to FF and SF groups. [1] |
| Managed care plans | For Medicare, the codes are accepted for medical nutrition therapy only. For commercial and Priority Health Choice (Healthy Michigan Plan and Medicaid) members they are accepted for MNT, nutrition education and nutrition counseling. [1] |
Check a Priority Health claim against the row
Before a Priority Health 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 Priority Health with another payer, then download the PDF of what you see.