Quick Billing Tips and Tricks

Do you have a burning billing question? We oftentimes receive questions from you – and there’s oftentimes overlap in the questions that you all need answers to! That’s why we’ve compiled a short list of questions and answers for you today to read and refer back to. We hope you find this helpful. And please let us know what questions you would add to this list – we’ll answer them in a future installment! 

How do I bill for a group visit? What is the minimum number of clients needed to constitute a group visit?

Answer: You can bill your group visit using CPT code 97804 – this is for a Medical Nutrition Therapy (MNT) Group Visit, which are billed in 30-minute increments. Two or more clients are needed to partake in the group session. Some insurance companies may only cover up to a certain number of clients in a particular group session; we have seen this vary by insurance company.

How do I bill for a husband and wife nutrition counseling session? 

Answer: You might have a scenario where a husband and wife ask you for a joint nutrition counseling session. If you spend 60 minutes with the husband and wife team, aim to bill 30 minutes for the husband’s visit using 97802 (if an initial visit) or 97803 (if a follow up visit), and 30 minutes for the wife’s visit (again using either 97802 or 97803). 

If another RDN has already seen a client, how do I handle billing?  

Answer: Be sure to check the limits of your client’s coverage; if they have already seen a dietitian prior to coming to your office, they may have already maxed out their nutrition counseling benefits for the year and will have to pay out of pocket. Healthy Bytes can step in to help determine remaining benefits for your client and thus what you are eligible to receive in reimbursement. If your client is a Medicare beneficiary, you can submit your claim using G codes for additional coverage. It is a best practice to learn from your new client whether this is their first visit with an RDN prior to their visit with you. 

If an MD has not provided a diagnosis code, can I use one? 

Answer: If you believe your client needs a diagnosis code to accompany his/her claim, you must receive that information from your client’s physician prior to submitting your claim. Ideally, you would receive this prior to your first visit with your client, in order to conduct an eligibility estimate and any necessary pre-authorizations.  

How do I file a telehealth nutrition counseling claim? 

Answer: Props to you for incorporating telehealth services into your practice! This opens up the number of clients you can see – and the number of client who can see you! You can generally use the same CPT codes when filing telehealth claims but may need a modifier or different place of service. Your Healthy Bytes billing ally is available to help ensure that these kinds of claims are filed accurately!

Let us know what billing questions – or tips – you have. Drop us a line below!