Nutrition & RDN Superbill Builder

Describe the visit

Initial, follow-up, group or DSMT

Describe the nutrition visit in your own words. Matching happens on this device only — never type a patient name here.

Matching runs on this device. Nothing you type is uploaded or saved.

Or tick what you observed

Diagnosis codes (ICD-10)

0 of 12 used

One primary diagnosis is required — the condition the nutrition therapy treats. It becomes pointer A; everything else is B–L.

Primary diagnosis — pointer A (required, choose one)Secondary diagnoses — pointers B–L (choose any)

Add another secondary code

Visit type, time & location

Time sets the units

Individual MNT bills in 15-minute units: under 8 minutes bills nothing, 8–22 minutes is 1 unit, 23–37 is 2, 38–52 is 3, 53–67 is 4. Group MNT and DSMT bill in 30-minute units.

Date of service

Total face-to-face minutes

60 min = 4 units of 97802.

Visit type

Referring provider (optional)

Referring provider NPI

Modifier AE is added to every line for registered dietitian services. Add a referring provider above to include modifier DN.

Procedure codes (CPT)

One individual MNT code

Pick one individual MNT code — 97802, 97803 or G0270. Group MNT and DSMT can be added alongside it, but MNT and DSMT on the same date need modifier 59.

Medical nutrition therapy — individual

Choose one

Individual MNT bills in 15-minute units: 8–22 minutes is 1 unit, 23–37 is 2, 38–52 is 3, and so on. 97802 is the first assessment of the year, 97803 every re-assessment after it, and G0270 a re-assessment after a second referral for a change in condition.

97802MNT initial assessment, each 15 minInitial assessment and intervention — the patient's first MNT visit.Suggested97803MNT re-assessment, each 15 minRe-assessment and intervention — every follow-up after the initial visit.G0270MNT re-assessment, new referral, each 15 minRe-assessment after a second referral in the same year for a change in diagnosis, condition or treatment.

Group medical nutrition therapy

Choose as needed

Group MNT bills in 30-minute units for two or more patients. Use G0271 instead of 97804 when the group session follows a second referral for a change in condition.

97804MNT group, each 30 minGroup MNT, two or more individuals, each 30 minutes.G0271MNT group, new referral, each 30 minGroup MNT after a second referral for a change in diagnosis or condition.

Diabetes self-management training (DSMT)

Choose as needed

DSMT is a separate benefit from MNT, billed per 30 minutes. If you bill DSMT and MNT on the same date, add modifier 59 to show they were distinct services.

G0108DSMT individual, per 30 minDSMT, individual, per 30 minutes.G0109DSMT group, per 30 minDSMT, group of two or more, per 30 minutes.

Travel & mileage

Non-covered line

Portal-to-portal travel is a patient-responsibility line — it carries no diagnosis pointer.

Modifiers, links & charges

Max 4 modifiers · max 4 links per line

AE, any telehealth modifier and DN are applied automatically. Units follow the minutes you entered — adjust them here if you billed differently.

Total fee charged for this visit

Lines total

$0.00

Auto-applied from your provider type and visit answers: AE. Adjust per line below.

Pick a procedure code above and the fee will split across your line items.

Locked rows keep their amount; the rest share what's left of the total.

Pick a primary diagnosis — every claim needs one.

No procedure codes selected yet.

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CMS-1500

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Your Practice Name

Provider Name, RDN

NPI —
Practice address
Phone · Email

Nutrition & Medical Nutrition Therapy

Patient Name

DOB

Insurance ID

Diagnoses — A is primary

No diagnosis codes

Procedure / CPT

No codes selected

POS

Modifiers used

—

Total Charge$0.00

Set Up Practice

Patient fields stay blank & fillable — no PII ever leaves your device.