Billing code 97803: Nutrition therapyMedicare rate & RVUs in Illinois
Report individual medical nutrition therapy for a follow-up reassessment and nutrition intervention, counted in 15-minute units of patient-facing service.
Medicare pays $30.50–$32.54 for 97803 in the office in Illinois, from Rest Of Illinois to Suburban Chicago. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 97803 covers
A registered dietitian or other qualified nutrition professional uses this service for an individual follow-up after the initial nutrition assessment. The visit may reassess dietary intake, progress toward nutrition goals, or changes in a condition affecting nutrition, then provide tailored counseling or revise the nutrition plan. It is commonly furnished in an outpatient office, although the code identifies the service rather than a particular setting.
Report 97803 for subsequent individual medical nutrition therapy, counting each 15 minutes of service with the patient. The record should support the follow-up nature of the visit, the nutrition issues reassessed, the intervention provided, and the time spent. Do not use it for the initial individual assessment or for nutrition therapy delivered to a group. CMS assigns work, practice-expense, and malpractice relative value units; the practice-expense values differ between office and facility settings.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 97803 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$30.50 to $32.54
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | $32.35 | $22.62 |
| East St. Louis | $30.76 | $21.85 |
| Rest Of Illinois | $30.50 | $21.65 |
| Suburban Chicago | $32.54 | $22.59 |
How the 97803 rate is calculated
Each of 97803’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 97803
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.45Practice expense 0.49Malpractice 0.01
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 97803
97803 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · 97803
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
Non-facility (office) rate · national
$31.73
The facility rate would be $22.04 (+$9.69). In a facility, the facility bills its own costs separately.
97803 compared with similar codes
Compare codes
97803 vs 97802 vs 97804 vs 98960: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 97802Medical nutrition therapy
- Choose 97802 for the initial individual nutrition assessment and intervention; 97803 is for a subsequent individual visit.
- 97804Group nutrition therapy
- Use 97804 when medical nutrition therapy is provided to a group. 97803 is for an individual patient.
- 98960Edu&trn pt self-mgmt nqhp 1
- 98960 describes individual self-management education and training. 97803 is for follow-up medical nutrition therapy, including reassessment and nutrition intervention.
97803 billing questions
How does 97803 differ from 97802?
97803 is for an individual follow-up reassessment and intervention. Use 97802 for the initial individual nutrition assessment and intervention.
Can 97803 be reported for a group session?
No. 97803 describes individual service; 97804 is the group medical nutrition therapy code.
How should units be counted?
The service is counted in 15-minute units. Document the time spent with the patient and the follow-up nutrition work performed.
What should the note support?
Document the nutrition concerns reassessed, the patient's progress or relevant changes, and the counseling or plan adjustment provided during the follow-up.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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