CPT code 97804: Medical Nutrition Therapy; group (2 or more), each 30 minutes

Ensure proper coding and billing for CPT code 97804 by following the documentation requirements and billing guidelines enumerated in our guide.

Use Code

What is the 97804 CPT code?

Current Procedural Terminology (CPT) code 97804, defined as "medical nutrition therapy; group, each 30 minutes", describes group medical nutrition therapy (MNT) services, delivered to two or more individuals by a qualified healthcare profession, with each unit representing 30 minutes of service.

This MNT code, maintained by the American Medical Association and falls under Medical Nutrition Therapy Procedures codes, involves the following:

Initial assessment and intervention based on a patient's nutrition needs in the context to the group's dietary habits and health condition
Development of general nutrition studies by a registered dietitian, nutritionists, or any qualified healthcare provider who can
Behavioral counseling for eating behaviors
Monitoring and follow-up on the progress

Do note that sessions must be interactive and clinically directed.

CPT code 97804 documentation requirements

For thorough documentation of CPT code 97804, the key elements must be present in the patient's medical records:

Patient demographics
Date, duration (in 30-minute increments), and content of session
Medical necessity and referral (e.g., diagnosis of diabetes, CKD)
Nutrition intervention
Monitoring and evaluation
Patient education; individual participation and response, if feasible.
Provider credentials (RD, RDN, or other qualified professionals) of the one providing nutrition counseling

CPT code 97804 billing guidelines

To ensure proper reimbursement for the MNT services of CPT code 97804, one must adhere to the following billing guidelines:

Bill per 30-minute increment.
Number of participants (must be ≥2).
POS must be stated.
Only applicable for group nutritional counseling sessions; for individual, use 97802 or 97803.
Medicare covers MNT for certain diagnoses and with a referral from a treating provider.
Verify payer policies especially if they have limits on the number of MNT units of visits that will be covered per patient per year.
Not typically billable by unlicensed nutritionists or health coaches.