Wiki Nutritionist Billing

[yem5173]

The FQHC that I currently work for hired a nutritionist and the company is looking for her to bill for everything possible. They want her to bill for diabetic teaching, cooking groups, healthy lifestyle groups and individual sessions. I have the basic billing information from our state Medicaid and some Medicare info. Does anyone else have information in regards to the limits and exceptions that a nutritionist can bill for? Thank you in advance.

 

[smeeks31]

Dietician Billing - FQHC

Medicare
The correct CPT code for Medicare is G0108 – DSMT, individual, per 30 minutes. This code is a
covered when performed at an FQHC. It is reimbursable for FQHC PPS payment as long as no other
office visit is performed. If it is performed on the same day as a physician visit. It will be
included as incident to physician services.

Medicaid
A dietician is not an approved practitioner to perform services in a FQHC for the encounter rate
payment. The services would be considered incidental to the physician services.
Commercial
Majority of the commercial payers will pay for dietician services for diabetes and ESRD. The payer
would need to be contacted to see if they credential the dietician. If not, the services would need
to be billed under the physician. Many will require a referral or authorization depending if the
patient has an HMO or PPO.


If you have any other FQHC questions or would like to swap concerns- Shanda.Meeks@CharlesDrew.com