Certified Dietitian-Nutritionist — Medical Nutrition Therapy (MNT) coverage and billing
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Defines coverage, billing, and prior authorization requirements for Medical Nutrition Therapy (MNT) services provided by certified dietitian-nutritionists to HUSKY Health members (HUSKY A, B, C, D), including limits, required ordering providers, and billing codes.
Effective July 1, 2025, independently enrolled certified dietitian-nutritionists may perform MNT services for HUSKY members when recommended/referred/ordered by specified licensed providers.
Medical Nutrition Therapy reimbursement is limited to CPT codes 97802-97804 and requires an ICD-10 diagnosis from Table 26 of the DSS Fee Schedule Instructions.
MNT services rendered in outpatient hospital clinics and FQHCs will be reimbursed (via CMAP Addendum B or encounter rate respectively) effective July 1, 2025.
Medical Nutrition Therapy Coverage Criteria
MNT coverage criteria
Conditions and billing requirements for covered Medical Nutrition Therapy (MNT) services:
ALL of the following
ALL of the following
- Certified dietitian-nutritionist must be independently enrolled and listed as the rendering provider on claims.
Claims must include the certified dietitian-nutritionist as the rendering provider.
ALL of the following
- MNT must be recommended, referred, or ordered by a licensed and CMAP-enrolled provider (physician, APRN, PA, or CNM) as specified by HUSKY plan.
Plan-specific language: HUSKY B and D explicitly require a licensed and CMAP-enrolled physician, APRN, PA, or CNM; HUSKY A and C reference similar requirements.
ALL of the following
- Medical Nutrition Therapy is limited to a total of 3 hours per calendar year per HUSKY Health member.
Site-of-service reimbursement rules
- Outpatient hospital clinic: MNT services performed by a certified dietitian-nutritionist will be reimbursed via CMAP Addendum B.
- Federally Qualified Health Center (FQHC): MNT services performed by a certified dietitian-nutritionist will be reimbursed by the FQHC encounter rate.
ALL of the following
- Out-of-network services: Not covered (Reference DSS PB 2025-18).
- Non-emergent out-of-state care requires prior authorization.
- Out-of-country care is generally not covered (limited exceptions for emergency/territory-specific circumstances per DSS guidance).
Billing Codes, Limits, and Diagnosis Requirements
Ordering, Referral, and Prior Authorization
Prior authorization and ordering: requirements for independently enrolled dietitian‑nutritionists
Independently enrolled certified dietitian-nutritionists may perform MNT when the service is recommended, referred, or ordered by a licensed and CMAP-enrolled physician, APRN, PA, or CNM (plan-specific language applies for HUSKY A, B, C, D). Claims must list the certified dietitian‑nutritionist as the rendering provider. Non-emergent out-of-state care requires prior authorization per DSS PB 2025-18.
- Services must be recommended/referred/ordered by a licensed and CMAP‑enrolled physician, APRN, PA, or CNM (plan-specific references for HUSKY A, B, C, D).
- Claims must include the certified dietitian‑nutritionist as the rendering provider to be reimbursed.
- MNT reimbursement is limited to CPT codes 97802–97804 and must include an ICD‑10 diagnosis code from Table 26 of the DSS Fee Schedule Instructions (see coding section).
- Non‑emergent out‑of‑state care requires prior authorization (per referenced DSS PB 2025‑18).
Definitions and Enrollment Requirements
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