G0270
MNT subsequent, 15 min, dx changed
Medical Nutrition Therapy (MNT) reassessment and subsequent intervention, individual, 15-minute increment, when there has been a change in the patient's condition, diagnosis, or treatment regimen requiring additional MNT beyond the routine annual benefit. CMS 2026 wRVU 0.45. Used after the initial MNT (97802) and routine subsequent MNT (97803) benefit has been exhausted for the year.
When to use it
Use G0270 when a Medicare beneficiary needs MNT beyond the annual benefit window because their clinical condition, diagnosis, or treatment plan has changed. Common scenarios: a T2DM patient with new diagnosis of CKD requiring renal-specific MNT, a CKD patient initiating dialysis, a newly diagnosed diabetic after the routine MNT annual hours have been used, a post-bariatric-surgery patient with new nutritional needs.
Full guidance
The Medicare annual MNT benefit covers 3 hours of MNT in the first year and 2 hours annually thereafter (97802 and 97803). Once those hours are used, G0270 covers additional MNT triggered by clinical change.
Documentation checklist
- ✓Initial MNT referral on file (the patient must have been referred for MNT and have received the routine annual MNT first).
- ✓Documented change in condition, diagnosis, or treatment regimen since the prior MNT episode. Examples: new GFR threshold, new comorbidity, new medication regimen affecting nutrition.
- ✓15-minute increment of individual MNT.
- ✓Performed by a registered dietitian or nutrition professional.
- ✓Care plan addressing the new nutritional requirements.
Common pitfalls
- !Without documented change in condition, use 97803 (routine subsequent MNT) instead. G0270 requires the change documentation.
- !Billing G0270 before the annual 97802 and 97803 hours are exhausted. The G0270 trigger is the change in condition AFTER routine annual MNT has been used.
- !Provider type mismatch. G0270 is billed by an RD or nutrition professional, not by the referring physician.
- !Missing the original referral. Medicare requires a physician referral for any MNT, including G0270.
- !Diagnosis must be one of the Medicare MNT-covered conditions (DM, CKD without dialysis, post-transplant). Other conditions are not covered.
Payer notes
Medicare covers MNT for diabetes and CKD without dialysis, with strict coverage rules: 3 hours initial year (97802), 2 hours annually thereafter (97803), plus G0270 increments when condition changes. Commercial coverage varies; many commercial plans cover MNT for diabetes and cardiovascular conditions with different annual caps. Documentation of the change-in-condition trigger is essential for G0270 audit defense.