Medicare Reimbursement for G0270 – Mnt Subs Tx for Change Dx

G0270 is a HCPCS Level II code describing medical nutrition therapy provided as a subsequent visit for a change in diagnosis, illness, or condition. This page shows the estimated Medicare Physician Fee Schedule (PFS) allowed amount for this code, both nationally and adjustable by locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

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How the amount is calculated

Medicare's PFS amount is built from three Relative Value Units (RVUs) assigned to a code: physician work, practice expense, and malpractice. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is furnished, reflecting local cost differences. The adjusted RVUs are summed and multiplied by the annual national conversion factor to produce the allowed amount. Practice expense RVUs are typically higher in the non-facility (e.g., office) setting than in the facility (e.g., hospital) setting, because facilities separately bill for overhead costs, which is why non-facility and facility payment amounts differ for the same code.

RVUs — work 0.45, practice expense 0.49 (non-facility) / 0.2 (facility), malpractice 0.01 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

• This is an estimate only, based on national averages and standard formulas; actual payment may differ.
• Medicare typically pays 80% of the approved amount after the annual Part B deductible is met; the patient or secondary insurer is responsible for the remainder.
• Modifiers, place-of-service coding, sequestration, and annual budget-neutrality adjustments can all change the final paid amount.
• Amounts vary by Medicare locality due to GPCI differences; always confirm the specific locality-adjusted rate.
• Coverage and payment are subject to Medicare Administrative Contractor (MAC) policies, medical necessity requirements, and any applicable local coverage determinations.
• Verify current-year rates with your MAC, as conversion factors and RVUs are updated annually and can change mid-year due to legislation.

Frequently asked

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Estimated Medicare Physician Fee Schedule amount. Medicare generally pays 80% after the deductible; actual amounts vary by locality, modifiers, sequestration, and annual updates. Verify with your MAC.