Prior Auth Required

97804 - • CPT Code – MNT, group (2 or more individual (s), each 30 minutes

This procedure appears on the selected insurer prior authorization source.

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Procedure / Service• CPT Code – MNT, group (2 or more individual (s), each 30 minutes
Procedure / Service Description

Providers offering MNT to Alliance members should use the following codes for authorization and claims - • CPT Code 97803 – MNT, re-assessment and intervention, individual, face-to-face with patient, each 15 minutes • CPT Code 97804 – MNT, group (2 or more individual (s), each 30 minutes • CPT-4 Code G0270 – MNT: reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional

Likely documents
  • Confirm benefit details
  • Submit clinical notes if requested by the plan
Next actions
  • Confirm the current plan policy before submission.
  • Use the insurer authorization workflow for this listed code.