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Nutrition billing turns on which diagnosis is on the claim and who referred the patient. Medical nutrition therapy codes 97802, 97803 and 97804 are timed in 15-minute units, Medicare covers them only for specific conditions with a physician referral, and commercial plans vary between a preventive benefit with no cost share and a limited visit allowance tied to medical diagnoses.
Registered dietitian billing has a narrow code set and sharply different coverage rules by payer, which makes verification the whole game.
Every denial gets a root cause, a fix and a feedback loop, so the same denial stops coming back.
Medicare denies MNT for diagnoses outside diabetes, kidney disease and transplant, and some plans exclude obesity counseling. Core MB confirms coverage by diagnosis at verification and advises the practice on patient responsibility before the visit.
Medicare MNT and many commercial plans require a referral on file before the first visit. We obtain and store the referral, track its date and request renewals when the covered year resets.
Many plans do not enroll dietitians individually or require a specific taxonomy. Core MB manages dietitian enrollment and determines where supervising physician billing is required instead.
Core MB bills nutrition services from the counseling note, selecting the code and diagnosis that reflect the visit and the payer's coverage rules, and tracking Medicare hours and referrals per patient. Dietitian credentialing and payer enrollment run in the same client portal. Credentialing for new providers runs in the same system, tracked live in your client portal.
Core MB provides the complete billing cycle for nutrition practices and dietitian groups, from the first benefits check to the credentialing that makes each dietitian billable.
Units follow documented face-to-face time in 15-minute increments, so an hour-long initial assessment supports four units of 97802 when start and stop times are recorded. Medicare limits total MNT hours per year, so Core MB tracks units against that annual allowance and uses G0270 or G0271 only when a documented change in condition supports additional hours.
Many commercial plans cover nutrition counseling as a preventive benefit with no cost share when the primary diagnosis is Z71.3 or a related preventive code, but apply a deductible or a visit cap when the primary diagnosis is a medical condition. We verify both benefit paths before the visit and code to accurately reflect the encounter and the patient's situation.
No, Medicare MNT coverage is limited to diabetes, chronic kidney disease and the period following a kidney transplant with a physician referral. Patients with prediabetes or obesity alone are not covered for MNT under the dietitian's own billing. Core MB identifies these patients at verification so the practice can discuss self-pay or other programs before the visit.
Complete the quote form with your payer mix, number of dietitians and software. We plan a transition that runs new claims alongside your current billing so there is no gap in collections, and credentialing or payer enrollment for your dietitians can start at the same time through the same portal.
Core MB verifies benefits by diagnosis, tracks Medicare MNT hours and referrals, and enrolls dietitians with payers for nutrition practices across the country.