Originally Posted: September 28, 2023
Last Updated: November 18, 2025
Description of HCPCS Code G0270
The description of procedure code G0270 is “Medical Nutrition Therapy; reassessment and subsequent intervention(s) following second referral in the same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes”.
Medicare Medical Nutrition Therapy Benefits
To understand HCPCS G0270, general Medicare Medical Nutrition Therapy (MNT) benefits need to be understood.
Medicare covers MNT for diabetes and chronic kidney disease. There is a limit of 3 hours for the first calendar year of nutrition counseling and 2 hours for every subsequent year. These visits are billed using CPTⓇ codes 97802 and 97803.
If additional hours of nutrition counseling are warranted, then the codes G0270 or G0271 will have to be used. Code G0270 is used for individual counseling while G0271 is for group counseling.
Requirements for Using HCPCS G0270
Additional hours of MNT, billed using G0270, are covered if medically necessary and ordered by a physician. A second referral from the physician must be obtained.
Documentation from Centers for Medicare & Medicaid Services (CMS) states that additional hours are medically necessary, “if the physician determines that there is a change in medical condition, diagnosis or treatment regimen related to diabetes or renal disease that requires a change in MNT and orders additional hours during that episode of care.”
Some dietitians interpret this information more liberally than others. If the patient is not understanding the education or is needing more information, this is not a change in status, so the patient does not meet the criteria for requiring additional visits. Here are some potential situations that I personally think meet the criteria:
- The patient has started insulin or has another major change in medication that could affect nutrition recommendations
- The patient was originally diagnosed with diabetes when you started meeting with them, but they have now developed chronic kidney disease as well
- There has been a major change in labs that has nutrition implications such as the patient developing hyperkalemia or hyperphosphatemia
The fact that MNT is limited to 2 or 3 hours per year for Medicare patients is disappointing, however, it is what CMS has decided on, and we should not be abusing the G0270 code as a loophole.
Getting the Additional Referral
At my office, we often have difficulty obtaining this second referral of the calendar year. Offices are generally confused on what we are asking for and will often sometimes just resend the original referral for that calendar year. We have had the most success faxing them a pre-filled out form that the provider just needs to sign. Here is our template:
Patient Name (Date of Birth)
This patient is being re-referred for nutrition counseling due to a change in their diagnosis, medical condition, and/or treatment per Medicare guidelines.
This patient has had a change of the following:
[type out of the specific change(s) that have occurred since the first referral of that calendar year was sent]
If you agree with the information above, please sign below.
Signature: (MD or DO only): _________________________
Date: _________________________
Be sure to include your fax number so the office can send the signed form back to you.
Frequently Asked Questions
How Many Additional Hours or Units Are Covered by Medicare?
CMS does not have a specified limit for additional hours.
Can HCPCS G0270 Be Used for Group Nutrition Counseling?
HCPCS G0270 cannot be used for group nutrition counseling. In this situation, HCPCS G0271 would be used instead.
What is the Reimbursement for G0270?
HCPCS G0270 has the same reimbursement rate as the MNT code 97803. Medicare fee schedules are public information and can be found using the CMS look-up tool. Dietitians get paid 85% of the fee schedule rate.
Just like CPT codes 97802 and 97803, G0270 is considered a preventive benefit by Medicare. This means that there is no patient responsibility as coinsurance and deductibles are waived.
Do Insurance Plans Other Than Medicare Cover G0270?
Original Medicare and Medicare Advantage Plans have coverage for G0270. Most commercial plans do not cover this code. Using G0270 is often not necessary with commercial plans as there may be an unlimited number of MNT visits to begin with.
References:
Power of Payment: Introduction to CPT Codes
Search the Physician Fee Schedule
Hello there!
Thank you for this helpful post! Do you know if a Medicare patient must use up their entire 97803 allotment before using the G0270 code? For example, if they have only 15 min left of 97803 for the year, and the visit is 30 minutes or more, can we bill G0270? If so, can we then go back and bill the remaining 97803 if they have a subsequent visit that fits their allotted time (in the prior example, a 15 minute visit)?
Thank you!
Hi Christine! I’ve never had this specific situation before and haven’t seen any information anywhere that explains what to do. I personally would, on the same claim, bill 98703 for however many units are left, and then on the next line, put G0270 for the remaining number of units the appointment was for.
Thank you for your response! Are you sure we could bill both codes at the same visit? I believe that you cannot bill a single visit as partially 97802 (or 97803) and partially as G0108. Thanks again!
In reference to this comment below:
“Just like CPT codes 97802 and 97803, G0270 is considered a preventive benefit. This means that there is no patient responsibility as coinsurance and deductibles are waived.”
According to my insurance, BCBS, CPT code G0270 is not considered preventive. Therefore, any nutritional counseling under this code requires a copay or coinsurance and the deductible may apply. Curious as to your source that the code is preventive.
That’s frustrating! Both of these government websites list G0270 under MNT which they are stating are preventive:
https://www.ngsmedicare.com/hu/preventive-services?lob=96664&state=97133&rgion=93623&selectedArticleId=907950
https://www.cms.gov/Medicare/Prevention/PrevntionGenInfo/medicare-preventive-services/MPS-QuickReferenceChart-1.html#MNT
If your BCBS is making patients with a Medicare Advantage plan pay something for G0270, that doesn’t sound right to me. I would try to contact your local MAC and get clarification if that is allowed.