G0270 Mnt subs tx for change dx

Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in 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

Medically Unlikely Edits (effective October 1, 2026)

Medicare pricing for G0270

Physician Fee Schedule (CY 2026, RVU26D)

Status A: active, paid separately under the PFS if covered. National amounts: non-facility $31.73, facility $22.04 (total RVUs 0.95 / 0.66 × $33.4009 conversion factor). Work RVU 0.45, practice expense RVU 0.49 non-facility and 0.20 facility, malpractice RVU 0.01. Global period XXX. Qualifying APM participants are paid at a $33.5675 conversion factor.

Payer policies and prior authorization for G0270

Payer coverage policies that name G0270

G0270 appears in 8 coverage policies from Aetna, Blue Cross & Blue Shield of Rhode Island, Capital Blue Cross, Premera Blue Cross, UnitedHealthcare.

PayerPolicyRole in policyReviewedDocument
AetnaIntensive Cardiac Rehabilitation Programs (0267)listed, no stanceMay 14, 2026payer document
AetnaNutritional Counseling (0049)covered if criteria are metMar 10, 2026payer document
AetnaPediatric Intensive Feeding Programs (0809)listed, no stanceDec 11, 2025payer document
AetnaWeight Reduction Programs and Devices (0039)covered if criteria are metMar 10, 2026payer document
Blue Cross & Blue Shield of Rhode IslandNutritional Counseling/Medical Nutritional Therapy
MEDICAL COVERAGE POLICY | 1
covered if criteria are metFeb 19, 2008payer document
Capital Blue CrossIntensive Pediatric Feeding Programs (MP 2.079)
Procedure Codes
covered if criteria are metSep 1, 2026payer document
Premera Blue CrossPreventive Carecovered if criteria are metSep 21, 2026payer document
UnitedHealthcarePreventive Care Services (MP.016.59)
Children and Adolescents | Medical Nutrition Therapy: | listed in this row for 0403T, 97802-
listed, no stanceJul 1, 2026payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN.

  • AZ: $4.88 (outpatient_hospital, RF133), effective Oct 1, 2025
  • LA: $27.16 (professional), effective Sep 8, 2023
  • MA: $20.59 (physician_medicine, facility), effective May 1, 2024
  • ND: $35.30 (physician), effective Aug 1, 2026
  • VA: $12.77 (medical, facility), effective Jul 1, 2022
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WY: $27.87 (professional), effective Jul 1, 2026

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.