Wellmark MNT coverage: codes and referrals
The short answerWellmark's policy 02.01.80 treats nutritional counseling as medically necessary for conditions where diet has a therapeutic role, when a physician prescribes it and a qualified provider such as a registered dietitian delivers it. It calls online or electronic counseling investigational.
By Javier Alvarez · Updated · 1 min read
1 row: Wellmark Blue Cross and Blue Shield. Public policy, not the member's benefits.
Wellmark
Medical Policy 02.01.80 Nutritional Counseling · IA, SD
| 97802 | Listed [1] |
|---|---|
| 97803 | Listed [1] |
| G0270 | Listed [1] |
| G0271 | Listed [1] |
| Where it applies | Wellmark Blue Cross and Blue Shield medical policy, reviewed November 2025. Benefits vary by contract and the policy may not apply to the Federal Employee Program. ACA individual plans cover preventive counseling at no cost share in network. [1] |
| Diagnoses | Medically necessary for diabetes mellitus, eating disorders, gastro-intestinal disorders, hypertension, kidney disease, seizures (ketogenic diet), and other chronic conditions such as arthritis, cancer, heart disease, liver disease and lung disease. Investigational for asthma, ADHD and chronic fatigue syndrome. [1] |
| Other codes | 97804, S9470 and S9452. [1] |
| Telehealth POS | Not published: call the payer. |
| Telehealth modifier | Not published: call the payer. |
| Telehealth rules | Nutritional counseling provided online or electronically is considered investigational. [1] |
| Visit limits | Not published: call the payer. |
| Referral and prior auth | Nutritional counseling must be prescribed by a physician. [1] |
| Who can bill | A physician or licensed qualified non-physician practitioner, which may include nurse practitioners, physician associates, clinical nurse specialists and registered dietitians. [1] |
| Payment | Prior approval is not applicable. The codes table lists place of service as office and outpatient. [1] |
- Wellmark: Medical Policy 02.01.80 Nutritional Counseling (review date November 2025), checked October 30, 2026
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Before a Wellmark 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 Wellmark Blue Cross and Blue Shield with another payer, then download the PDF of what you see.