Rhode Island insurance law on MNT and nutrition counseling
The short answerRhode Island requires covered health plans to include diabetes self-management education, with information on the nutritional management of diabetes, and education relating to medical nutrition therapy. Visits are limited to specific triggers and a physician must prescribe them.
By Javier Alvarez · Updated · 1 min read
1 row: State insurance law · Rhode Island. Public policy, not the member's benefits.
Rhode Island insurance law
Fully insured plans (R.I. Gen. Laws 27-18-38) · Rhode Island
| 97802 | Not published |
|---|---|
| 97803 | Not published |
| G0270 | Not published |
| G0271 | Not published |
| Where it applies | Individual or group health insurance contracts, plans or policies that include coverage for physician office services, and major medical policies and the other broad medical policies the law names. Supplemental policies for specified diseases are excepted. [1] |
| Diagnoses | Insulin treated diabetes, non-insulin treated diabetes, and gestational diabetes. [1] |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | Not published: call the payer. |
| Visit limits | Self-management education and medical nutrition therapy education is limited to medically necessary visits upon diagnosis of diabetes, when a physician diagnoses a significant change in symptoms or conditions, or when reeducation or refresher training is necessary. Home visits are included when medically necessary. Group settings are allowed. [1] |
| Referral and prior auth | The education must be medically necessary and prescribed by a physician. It may be provided only by the physician or, on the physician's referral, by an appropriately licensed and certified healthcare provider. [1] |
| Payment | Copayments or deductibles may not be greater than those for other supplies, equipment or physician office visits. Benefits are reimbursed under each insurer's own reimbursement principles and mechanisms. [1] |
- Rhode Island General Laws s. 27-18-38, Diabetes treatment (Rhode Island General Assembly), checked October 30, 2026
What the Rhode Island law says
- Where it applies. Individual or group health insurance contracts, plans or policies that include coverage for physician office services, and major medical policies and the other broad medical policies the law names. Supplemental policies for specified diseases are excepted.
- Diagnoses. Insulin treated diabetes, non-insulin treated diabetes, and gestational diabetes.
- Visit limits. Self-management education and medical nutrition therapy education is limited to medically necessary visits upon diagnosis of diabetes, when a physician diagnoses a significant change in symptoms or conditions, or when reeducation or refresher training is necessary. Home visits are included when medically necessary. Group settings are allowed.
- Referral and prior auth. The education must be medically necessary and prescribed by a physician. It may be provided only by the physician or, on the physician's referral, by an appropriately licensed and certified healthcare provider.
- Payment. Copayments or deductibles may not be greater than those for other supplies, equipment or physician office visits. Benefits are reimbursed under each insurer's own reimbursement principles and mechanisms.
What it means for a claim in Rhode Island
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 Rhode Island, 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 Rhode Island: BCBS of Rhode Island. The state laws side by side compare Rhode Island with other states.