Massachusetts insurance law on MNT and nutrition counseling
By Javier Alvarez · Updated · 1 min read
1 row: State insurance law · Massachusetts. Public policy, not the member's benefits.
Massachusetts insurance law
Fully insured plans (M.G.L. c. 175, s. 47N) · Massachusetts
| 97802 | Not published |
|---|---|
| 97803 | Not published |
| G0270 | Not published |
| G0271 | Not published |
| Where it applies | Individual accident and sickness policies and group blanket policies that provide hospital and surgical expense insurance, except policies supplementing Medicare or other governmental programs. Benefits apply to items within a category of benefits the policy otherwise covers. [1] |
| Diagnoses | Insulin-dependent, insulin-using, gestational, and non-insulin-dependent diabetes. [1] |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | Not published: call the payer. |
| Visit limits | Not published: call the payer. |
| Referral and prior auth | Items must be prescribed by a health care professional legally authorized to prescribe them and be medically necessary. [1] |
| Who can bill | A certified diabetes health care provider participating with the insurance contract or affiliated with a participating provider. The statute defines this as a licensed health care professional with expertise in diabetes, a registered dietician, or a certified diabetes educator. The insurer need not contract with one it does not already contract with. [1] |
- Massachusetts General Laws: Part I, Title XXII, Chapter 175, Section 47N, checked October 30, 2026
What the Massachusetts law says
- Where it applies. Individual accident and sickness policies and group blanket policies that provide hospital and surgical expense insurance, except policies supplementing Medicare or other governmental programs. Benefits apply to items within a category of benefits the policy otherwise covers.
- Diagnoses. Insulin-dependent, insulin-using, gestational, and non-insulin-dependent diabetes.
- Referral and prior auth. Items must be prescribed by a health care professional legally authorized to prescribe them and be medically necessary.
- Who can bill. A certified diabetes health care provider participating with the insurance contract or affiliated with a participating provider. The statute defines this as a licensed health care professional with expertise in diabetes, a registered dietician, or a certified diabetes educator. The insurer need not contract with one it does not already contract with.
What it means for a claim in Massachusetts
The law sets a floor for the plans it reaches; the plan's own policy and the member's contract still decide the codes, units and referral. On the benefits call, ask whether the plan is fully insured in Massachusetts, and if a covered service is denied, name the statute by section in the appeal. The sources below link to the statute itself.
Payers with their own row for Massachusetts: MassHealth (Massachusetts Medicaid), Blue Cross Blue Shield of Massachusetts and Fallon Health. The state laws side by side compare Massachusetts with other states.