Author name: Amy Shults, RDN, CDN, CDCES

Additional hours of medical nutrition therapy for Medicare beneficiaries are covered if medically necessary and ordered by a physician. These additional visits are billed with HCPCS codes G0270 or G0271. Original Medicare and Medicare Advantage Plans have coverage for G0270 while most commercial plans do not cover this code.

An ICD-10 code is a type of medical code used to represent diagnoses, symptoms and procedures. Dietitians need to use ICD-10 codes to bill insurance companies for nutrition counseling services. However, diagnosing medical conditions is not in a dietitian’s scope of practice, so using ICD-10 codes has to be done carefully.

Procedure code G0108 is defined as, “diabetes outpatient self-management training services, individual, per 30 minutes.” This code is used to bill for diabetes education that is provided one-to-one. Patients may be educated on topics such as Pathophysiology of diabetes, treatment options, coping strategies, nutrition, physical activity, blood sugar monitoring and behavior change strategies.

Intensive Behavioral Therapy (IBT) for cardiovascular disease is a preventive benefit for all Medicare beneficiaries, and is billed using HCPCS code G0446. This benefit can be billed annually and needs to be provided in a primary care setting by or incident to a physician or other primary care provider.

Intensive Behavioral Therapy (IBT) for obesity is a preventive benefit for Medicare beneficiaries that have a body mass index (BMI) of 30 or greater. The service involves a nutrition assessment, as well as interventions on diet and exercise, for weight loss. There are many nuances and specifics for billing this benefit.